Name of the Procedure:

Fine Needle Aspiration Biopsy (FNAB or FNA), including CT Guidance; Each Additional Lesion

Summary

A Fine Needle Aspiration Biopsy (FNAB or FNA) using CT guidance for each additional lesion is a minimally invasive procedure where a thin, hollow needle is used to extract a small sample of tissue or fluid from a suspicious area for analysis. CT guidance ensures precise targeting of lesions that may not be easily accessible.

Purpose

This procedure is used to diagnose the nature of abnormalities, such as tumors, growths, or infections, in areas that might be difficult to reach otherwise. The primary goal is to determine whether a lesion is benign or malignant, which aids in developing an appropriate treatment plan.

Indications

• Presence of abnormal growths or lesions detected through imaging tests (e.g., CT scan, MRI, or ultrasound).
• Unexplained lumps or masses.
• Suspicion of cancer or infection.
• Monitoring of known conditions for changes.

Preparation

• Patients may be asked to fast for several hours before the procedure.
• Medications such as blood thinners may need to be adjusted.
• Pre-procedure imaging or blood tests may be required to confirm the target area's location and feasibility for biopsy.

Procedure Description

1. Preparation: The patient lies on a CT scanner table, and the target area is cleaned and sterilized.
2. CT Imaging: Initial CT scans are taken to accurately locate the lesion.
3. Needle Insertion: Under CT guidance, a fine needle is carefully inserted into the lesion.
4. Sample Collection: Tissue or fluid samples are aspirated using the needle.
5. Repeat for Additional Lesions: If additional lesions are present, the process is repeated for each one.
6. Completion: The needle is removed, and a small bandage is applied to the entry site.

The procedure typically uses local anesthesia to numb the target area, with sedation options if necessary to maintain patient comfort.

Duration

The procedure generally takes about 30 minutes to 1 hour per lesion, depending on the location and complexity of the lesions.

Setting

FNABs with CT guidance are usually performed in a hospital’s radiology department or an outpatient imaging center equipped with CT technology.

Personnel

• Radiologist or specialized physician performing the biopsy.
• Radiologic technologists operating the CT scanner.
• Nurses for patient care and monitoring.

Risks and Complications

• Minor bleeding or bruising at the biopsy site.
• Infection at the needle insertion site.
• Rarely, damage to adjacent structures (e.g., blood vessels, organs).

• Pneumothorax (if the needle punctures a lung).

  Complications are generally managed through observation and appropriate medical interventions.

Benefits

• Minimally invasive with a quick recovery.
• Provides critical diagnostic information to guide treatment.
• Enables targeted sampling with high accuracy due to CT guidance.

Recovery

• Mild pain or discomfort at the biopsy site, usually managed with over-the-counter pain relievers.
• Patients typically resume normal activities within a day, though heavy lifting or strenuous activity might be restricted for 24-48 hours.
• Follow-up appointment to discuss biopsy results and next steps.

Alternatives

• Core Needle Biopsy: Uses a larger needle to obtain a larger tissue sample.
• Surgical Biopsy: More invasive, requiring an incision and potential for longer recovery.
• Imaging Surveillance: Monitoring the lesion without doing a biopsy initially.

Each alternative varies in invasiveness, diagnostic yield, and recovery time.

Patient Experience

During the procedure, patients might feel a brief pinch or pressure when the needle is inserted. Post-procedure soreness is generally mild and temporary. Prompt communication ensures comfort and reassurance throughout the process.