This leaflet provides information about the test you are due to have. It should replace the discussions you have with the doctors and nurses involved in your care, If you have any queries or questions please do not hesitate to ask the staff looking after you.
What is a CT guided lung biopsy?
It is a biopsy procedure done by the radiology (x-ray) doctor. It involves you lying on the CT scan table, the doctor will then anaesthetise the skin and then pass a fine needle through to the lung shadow seen on the scan and take a sample. The sample is then sent for analysis to the laboratory. Why has the test been advised? The biopsy can give the doctor information that may help to understand why you have been experiencing the symptoms you have or why your chest scan is abnormal. It can rule out or diagnose conditions and help to make treatment decisions.
Is there an alternative test?
This depends on your symptoms or your medical conditions. A lung biopsy gives very specific information. Your doctor will discuss alternatives if possible.
How do I prepare for the test?
- Eating and drinking – you can eat and drink as normal but avoid heavy meals, as you may need to lie on your front during the test.
- Medication – you should have been advised to stop any blood thinning medication i.e. aspirin, warfarin, clopidogrel, heparin injections. If you have not been given advice please ring your consultant’s secretary asap.
- Consent form – you will have test explained to you and asked to sign a consent form, this will give you an opportunity for questions.
What will happen before the test?
The radiology doctor in the CT department will go through what to expect.
A cannula (tiny plastic tube) is inserted into your vein usually in your arm, so that the scan dye can be given. You will be asked to lie on the scanning table, which will be the same or similar to one you have seen before when you had your CT scan. The staff will position you so that you are comfortable and in a position that allows the doctor to do the biopsy.
The staff will advise you to keep still as best you can and be available to you throughout the procedure. The doctor will inject your skin with an anaesthetic so that it goes numb before he passes the biopsy needle.
Once the biopsy sample has been obtained, the needle will be quickly removed and you will be taken back to the ward.
How long does the test take?
It takes approximately 30 minute although you will need to be on the ward a couple of hours before and afterwards.
What are the risks with this test?
The test is a safe procedure but all procedures have risks but complications are rare. The risks include bleeding and air can leak into the space surrounding your lung (pneumothorax), often no treatment is needed. Very occasionally treatment with a tube to drain the air is advised and this would involve staying in hospital until resolved. Any risks will be discussed with you at the time of you signing your consent form.
What happens after the test?
A nurse will look you after until you leave the hospital. Your breathing rate, heart rate and blood pressure will be checked. You will be advised to rest on your bed/chair after the biopsy until the check chest x-ray is done. You will have a chest x-ray 2 hours after the biopsy, this is to check if any air has leaked around your lung. You may cough up some blood or blood stained sputum, this is normal and usually ceases within 24 hours. If you feel unwell please inform the nursing staff. You can eat and drink as normal, unless advised otherwise.
Results of the test
The biopsy samples will take approximately 5-10 days to be processed, so a follow up appointment will be arranged for after this time for you to see the Consultant who referred you for the biopsy test. The arrangements of this appointment will be discussed with you prior to going home.
Going home and usual activities
You will be able to go home, once your chest x ray has been reviewed and no air leak found and you are feeling well enough to go home.
You will need somebody to accompany you home and to stay with you for 24 hours. If this is not possible please discuss this with the secretary or the nurse on the ward.
We advise you should rest for the remainder of the day/night. Most people feel able to resume normal activities after 24 hours.
If you cough up large amounts of blood, develop chest pain, worsening breathlessness, fever or become unwell, please seek medical attention. You will have a plaster over the biopsy area that can be removed the next day and we expect will be dry, if there is any swelling or bleeding seen you should seek medical advice.