Having a biopsy in Interventional Radiology

Information about having a biopsy in the Interventional Radiology department at Great Ormond Street Hospital.

A biopsy is when a small sample of tissue is taken from the body for testing. The sample is then examined under a microscope and tested chemically in the laboratories.

Any area of the body can be biopsied. A biopsy may be suggested if your child has developed a new, undiagnosed lump or has an abnormal area of tissue within an organ. Biopsies can help us to make a diagnosis or to assess the effects of certain treatments.

Your child may need to come to GOSH for a pre-admission assessment. This is to check that they are well enough to have the biopsy. This appointment may involve taking blood samples and other tests.

You will have already received an admission letter which contains more information on how to prepare for the procedure.

If your child takes regular medication, please speak to your child’s team about when to stop these before the procedure.

Your child needs to be fasted for the procedure for the general anaesthetic. As a general rule:

Food and milk:

• Breast-fed babies- can have their last feed three hours before the procedure. Breast milk is digested faster than solid food or formula.
• Bottle-fed babies and children- can have their last milk feed, food or milk drink, six hours before the procedure. They should not have any food or milk after this time.

Water:

• All babies and children can have a drink of water (but no other fluids), until one hour before the procedure.

Please follow these instructions carefully, otherwise your child’s procedure may be delayed or even cancelled.

Your child will be admitted to a bed on a ward.

The person bringing your child to the procedure should have ‘parental responsibility’ for them. Parental responsibility refers to the individual who has legal rights, responsibilities, duties, power and authority to make decisions for a child. If the person bringing your child does not have parental responsibility, we may have to cancel the procedure.

Sometimes a biopsy is suggested while your child is still in hospital.

An anaesthetist will visit to talk to you about your child’s anaesthetic. The doctor or specialist will explain the procedure in more detail; discuss any worries you may have and ask you to sign a consent form giving permission for your child to have the procedure. If your child has any medical problems, please tell the doctors. You and your child will then be brought to the Interventional Radiology (IR) suite within the X-ray department for the biopsy.

Once your child is under general anaesthetic (asleep), the specialist will inject local anaesthetic around the biopsy area to make it numb for a few hours. They will use different imaging techniques, such as ultrasound, X-rays or a CT scan, to locate the precise area to be biopsied.

Once located, a small cut is made into the skin and a biopsy needle is inserted into the tissue. The needle has a hollow centre and is used to take several tissue samples.

After the samples are taken, the specialist will ‘plug’ the biopsy area with a substance to help reduce bleeding. This substance is harmless and will be absorbed by the body over the next few months.

The area will then be covered with a dressing.

Your child will be having the procedure under general anaesthetic. Every anaesthetic carries a risk, but this is extremely small.

There is a small risk of bleeding during and after the biopsy procedure, but ‘plugging’ the biopsy tract reduces this greatly. Plugging the biopsy track also reduces the chance of cells spilling into surrounding tissues. This is particularly important if the abnormal tissue is cancerous.

There is a chance that the biopsy procedure may have to be repeated if there is a problem with the tissue samples collected, such as too few samples being collected, or if the diagnosis is particularly complicated.

The procedure may involve the use of X-rays. The levels that are used are low dose and therefore low risk. If you have any concerns regarding the use of radiation, please discuss this with the person performing your procedure beforehand.

As the procedure involves the use of X-rays, legally, we must ask anyone over the age of 12 whether there is any chance they might be pregnant.

We will also ask for the first date of their last period (if started). This is to protect babies in the womb from receiving unnecessary radiation.

Your child will return to the ward after they have recovered from the anaesthetic. Some children feel sick and vomit after a general anaesthetic. Your child may have a headache or sore throat or feel dizzy, but these side effects are usually short- lived and not severe. Your child can start eating and drinking as normal once they feel like it.

The doctors will come to check your child’s progress on the ward and will give you some information about what they have done during the procedure.

The dressing over the area should be kept clean and dry for the next few days.

If your child does not need to stay in hospital for treatment, you can return home once they have recovered from the anaesthetic or sedation.

You should call the hospital if:

• The biopsy site looks red, swollen and feels hotter than the surrounding skin
• The biopsy site is oozing
• Your child is in a lot of pain and pain relief does not seem to help
• Your child has a temperature of 38°C or higher

You can call the ward by calling the GOSH switchboard and asking for the ward your child was discharged from.

Telephone: 020 7405 9200

If you are unable to get through, please call NHS111 by dialling 111.

The results will not be available straightaway.

The initial results of the biopsy are usually available within a couple of days, but more complicated tests can take longer.

All the biopsy results will be given to you at your child’s next outpatient appointment, but if there is a need to change your child’s treatment before this time, you will be contacted directly by your child’s doctor or via your family doctor (GP).

If you have any questions, please speak to you child’s doctor or nurse or call Interventional Radiology.

Telephone: 020 7405 9200 extension 7943.

You can also contact us through MyGOSH.