Guided Biopsy Ultrasound Scan

A Guided Biopsy Ultrasound Scan uses real-time ultrasound to steer a thin needle into the exact area of concern, making it far more accurate than a blind “freehand” biopsy. At Cadabams Diagnostics Bengaluru, this outpatient service is available daily with most reports delivered within 48–72 hours.

Role of Real-Time Ultrasound Imaging

Ultrasound sends harmless sound waves into the body and bounces them back to create a live picture. During the biopsy, the radiologist watches this live feed to:

• Confirm the lesion’s exact location
• Avoid blood vessels and nearby organs
• Adjust the needle path in real time

How Ultrasound-Guided Biopsy Differs from Other Image-Guided Biopsies

• No radiation (unlike CT)
• Portable & faster setup (unlike MRI)
• Ideal for superficial or moderately deep masses

Common Body Areas Targeted

• Breast – suspicious lumps or micro-calcifications
• Thyroid – nodules >1 cm or with suspicious features
• Liver – focal lesions seen on ultrasound or CT
• Lymph nodes – enlarged or abnormally shaped nodes

1. Fine-Needle Aspiration (FNA) – thin needle, small sample for cytology
2. Core Needle Biopsy (CNB) – spring-loaded device, tissue “core” for pathology
3. Vacuum-Assisted Biopsy (VAB) – larger samples via suction, ideal for micro-calcifications

• Lesion size, shape, echogenicity
• Vascularity on colour Doppler
• Needle trajectory and safety margin to vessels

• Confirm benign vs malignant nature of a mass
• Plan treatment pathway—surgery, chemotherapy, or radiotherapy
• Avoid unnecessary open surgical biopsy

• Suspicious lumps detected on routine ultrasound or mammogram
• Enlarged lymph nodes persisting beyond 2–4 weeks
• Thyroid nodules that have grown or changed texture
• Abnormal liver or kidney lesions picked up on scans

• Real-time needle guidance increases accuracy to >95 %
• No radiation exposure—safe for children and pregnant patients
• Outpatient procedure with <30 minutes of downtime

• Breast cancer (ductal & lobular carcinoma)
• Thyroid carcinoma (papillary, medullary)
• Lymphoma (Hodgkin & non-Hodgkin)
• Hepatocellular carcinoma

• Abdominal site: fast 4–6 hours
• List current medications—especially blood thinners
• Wear loose clothing and arrange local transport
• Bring prior imaging reports for comparison

• Recent coagulation profile (PT/INR, platelet count)
• Signed informed consent
• Previous imaging reports on hand

• Abdominal biopsies: early morning slots to reduce bowel gas
• Breast biopsies: days 7–14 of menstrual cycle to minimize tenderness

• Adults with accessible superficial or moderately deep lesions
• Not recommended for uncontrolled bleeding disorders (INR >1.5, platelets <50,000)

1. Positioning & skin marking under ultrasound
2. Local anaesthesia injection (stings for ~5 seconds)
3. Real-time ultrasound needle placement and sample extraction
4. Post-procedure compression and sterile dressing

• Discontinue anticoagulants 48–72 hrs after physician approval
• Report allergy to local anaesthetics (lidocaine)

• Minimal bleeding or bruising at the needle site
• Rare infection risk (<1 %) kept low with sterile technique
• Deep or obscured lesions may still require CT guidance