Name of the Procedure:

Fine Needle Aspiration Biopsy (FNAB) with MR Guidance; First Lesion

Summary

A Fine Needle Aspiration Biopsy (FNAB) with MR (Magnetic Resonance) guidance is a procedure where a thin needle is used to remove a small tissue sample from a lesion for examination under a microscope. The MR guidance helps in precise targeting of the lesion. This description pertains to the first lesion being sampled.

Purpose

FNAB with MR guidance is conducted to diagnose abnormalities, such as tumors, cysts, or infections, in various body tissues. The goal is to gather cells for examination to determine the nature of the lesion (benign or malignant) and to guide treatment planning.

Indications

• Unexplained lumps or masses.
• Lesions identified on imaging studies (MRI, CT scan, ultrasound).
• Suspicion of cancer or other abnormal tissue growths.
• Monitoring changes in known lesions. Patients who present with any of these symptoms or conditions may be candidates for the procedure, especially when other diagnostic methods are inconclusive.

Preparation

• Patients may be required to fast for a few hours before the procedure.
• Certain medications, especially blood thinners, may need to be adjusted or stopped.
• Pre-procedure imaging studies or lab tests might be needed.
• Obtain consent and review the procedure with healthcare providers.

Procedure Description

1. The patient is positioned comfortably, typically lying down.
2. An MRI machine is used to obtain detailed images and pinpoint the lesion.
3. The skin over the lesion is cleaned and sterilized to prevent infection.
4. Local anesthesia is administered to numb the area.
5. A thin needle is inserted into the lesion under MR guidance.
6. Tissue or fluid samples are withdrawn through the needle.
7. The needle is removed, and slight pressure is applied to the biopsy site.
8. A small bandage is placed over the site.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

FNAB with MR guidance is usually performed in a hospital's radiology or imaging department.

Personnel

• Radiologist or specialist performing the biopsy.
• Radiologic technologist assisting with MRI guidance.
• Nurse for patient care and monitoring.
• Sometimes an anesthesiologist if deeper sedation or anesthesia is needed.

Risks and Complications

• Mild pain or discomfort at the biopsy site.
• Bleeding or bruising.
• Infection at the biopsy site.
• Rarely, damage to surrounding tissues or organs.
• Pneumothorax (collapsed lung) if near lung tissue.

Benefits

• Minimally invasive with a quicker recovery than surgical biopsies.
• Precise sampling of the lesion due to MR guidance.
• Rapid diagnosis, aiding in timely treatment decisions.
• Reduced complications compared to more invasive procedures.

Recovery

• Mild discomfort or soreness can be expected; over-the-counter pain relievers are usually sufficient.
• Keep the biopsy site clean and dry; a bandage may be applied for a day.
• Patients can typically return to normal activities the next day.
• Follow-up appointment to discuss biopsy results and further treatment if necessary.

Alternatives

• Core needle biopsy: uses a larger needle but may not be as precise as FNAB with MR guidance.
• Surgical biopsy: more invasive, with a longer recovery time.
• Observation: in some cases, monitoring the lesion over time with periodic imaging may be an option.

Patient Experience

During the procedure, patients might feel slight pressure or a pinch when the needle is inserted. Local anesthesia often ensures minimal pain. After the biopsy, mild soreness or bruising can occur but is generally manageable with simple analgesics.