What is a biopsy?
A biopsy is a diagnostic method in which a certain number of tissue cells are taken for their subsequent study - histological examination. It is prescribed for oncological diseases and some other pathologies, when neoplasms are detected. Biopsy is an important method of clarifying diagnosis, which allows you to make a final diagnosis and determine the type of pathology and many of its characteristics.
Ultrasound-guided biopsy is a highly informative ultrasound diagnostic method that allows you to examine an organ and obtain accurate information about an existing neoplasm. The entire manipulation process is displayed on a computer monitor. The doctor sees the location of the areas of interest to him, which makes the procedure as accurate, informative and safe as possible, unlike a “blind” biopsy, in which the risk of damaging nearby tissues is higher.
With the help of a biopsy, it is possible to determine the benignity or malignancy of a neoplasm, to distinguish inflammation from an abscess, and also to choose the most effective method of treating a detected pathology, to justify the need or unnecessary operation.
Ultrasound-guided biopsy has the following features:
- High diagnostic accuracy. Thanks to the control of the procedure using ultrasound guidance, the specialist performing the manipulation takes the material exactly from the desired area. This is especially valuable in cases where pathological foci have a heterogeneous structure or are located deep inside the body.
- The minimally invasive ultrasound-guided procedure guarantees minimal risk of damage to nerves or blood vessels, reduces the likelihood of complications, severe pain, or dysfunction of internal organs.
- High swipe speed. Ultrasound control during a biopsy speeds up the process of searching for a suspicious area inside the organ and taking material from it. As a result, the biopsy time is reduced to 15-25 minutes.
- Safety for the health of the patient.
Main types of ultrasound-guided biopsy:
- Puncture biopsy under ultrasound guidance. The specialist inserts a syringe into the detected neoplasm, then takes a column of tissue material or liquid for cytological examination. This procedure is painless and does not require additional anesthesia. It is used for superficially located tissues and organs (lymph nodes, thyroid and mammary glands, neoplasms of superficial soft tissues). There is a core-needle biopsy under ultrasound guidance or a fine-needle biopsy, depending on the thickness of the needle.
- Trephine biopsy under ultrasound control. The procedure is performed with preliminary local anesthesia using a trephine needle, which is loaded into a special device - a “biopsy gun”, and then inserted into the formation to collect histological material. A trephine biopsy performed under ultrasound control makes it possible not to make a mistake and take a sample of the desired tissue.
- Stereotactic biopsy under ultrasound guidance. A procedure for taking tissue samples from multiple sites in an organ. Under the control of ultrasound, the doctor has the opportunity not to lose sight of the neoplasm, the tissues of which must be taken for histological analysis.
- Aspiration biopsy. This is the collection of tissue fragments of the endometrium of the uterus using a special device resembling a syringe that creates low pressure and sucks tissue fragments of the mucous membrane of the uterine cavity. A more advanced method of aspiration biopsy is a pipel biopsy, for which a pipel tip is used.
Different types of biopsy are used in different situations. The use of the fine-needle biopsy method, carried out under ultrasound control, allows the doctor to choose the optimal treatment tactics and significantly reduce the risk of complications.
Puncture can be performed both through the skin and through the lumen of hollow internal organs (intestine, stomach or esophagus). In the latter case, a biopsy is performed using special endoscopic equipment. When it is carried out in a hollow organ of the patient, the doctor, under the control of ultrasound, introduces an endoscope, at the end of which there is an ultrasonic sensor. This technique makes it possible to bring the sensor as close as possible to the examined area, obtain highly informative images and perform a needle biopsy of the altered tissue.
This method makes it possible to obtain tissue samples necessary for research from almost any organs, even those that are located far from the surface of the skin and have very small dimensions - less than 10 mm. The risk of complications when using it is minimal and does not exceed one or two percent.
Which organs are biopsied under ultrasound control
Ultrasound-guided biopsy is used to take tissue material from the following organs:
- mammary glands;
- ovaries;
- thyroid gland;
- prostate gland;
- pancreas;
- soft tissues;
- lymph nodes;
- liver;
- spleen;
- kidneys;
- pelvic organs;
- organs and tissues of the retroperitoneal space.
A breast biopsy under ultrasound control is prescribed if there are seals in the mammary gland, cysts, when there is discharge from the nipple or enlarged lymph nodes, as these symptoms may indicate oncology, breast cancer. With the help of ultrasound, the structure of the organ and all places that are suspicious are visible. To collect cells and tissue from the mammary gland, methods such as puncture biopsy or trephine biopsy are used.
A biopsy of the endometrium of the uterus under ultrasound control is prescribed if tumors, polyps or other pathological changes in this layer are detected. Thanks to ultrasound, this process proceeds with greater accuracy, since it is possible to examine the uterine cavity well, and without the unnecessary trauma that curettage causes. An aspiration biopsy is used to collect uterine cells.
An ultrasound is not required during a biopsy to collect cells from the cervix and other visible areas.
When is an ultrasound-guided biopsy needed
Indications for ultrasound-guided biopsy are the following pathological conditions:
- suspicion of a malignant tumor in the organs;
- fluid accumulation in the joint, pleural region, abdomen, etc.;
- any pathological processes, the cause of which is not clear.
Any formations found during the examination is a reason to refer the patient to an oncologist, who will already prescribe a biopsy to determine the nature of the tumor (benign or malignant tumor) during cytological, histological, immunohistochemical analysis and choose a cancer treatment method.
How an ultrasound-guided biopsy is performed
The patient assumes a horizontal position and, if required, anesthesia is performed, local anesthesia of the area through which the biopsy will be performed. Under the control of ultrasound, the specialist determines the localization of the neoplasm in the tissues of the organ and collects its tissues. Painful sensations in the patient, as a rule, are absent, but a burning sensation, slight tingling may be felt. The puncture site at the end of the biopsy is treated with an anesthetic and, in some cases, ice is applied. The area of skin through which the biopsy was performed heals within a few days. During this period, it is better to avoid heavy physical exertion.
