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Biopsy Procedures

Emory Decatur Hospital and Emory Hillandale Hospital offer a wide-range of diagnostic biopsy procedures to remove cells from a suspicious area for laboratory examination. Biopsy procedures can be performed using surgery if the suspicious area is near the skin’s surface or can be removed during surgery. A biopsy may be performed to determine if a tumor is cancerous or to determine the cause of unexplained infection or swelling.

A biopsy, or tissue sampling, allows for removal of specific cells so they can be in the laboratory for a diagnosis. Some biopsy procedures can be done in the physician’s office while others require an outpatient clinic or hospital setting. Some biopsies require use of an anesthetic to numb the area while others don’t require any medication or sedation.

Today, many biopsy procedures use various imaging technology and procedures to assist with securing the tissue from the suspicious area and to reduce the need for a large incision. Common biopsy sites include breast, prostate, liver, thyroid, skin, kidney, lung and gastrointestinal tract. Abnormal biopsies may mean you have a disease like cancer, but it depends on the individual biopsy.

While some X-rays can detect masses or abnormalities, they can’t differentiate normal cells from cancerous cells. This is when a biopsy is performed to run test on the tissues that have been removed during the procedure.

Types of Atlanta Biopsy Procedures

Emory Decatur Hospital and Emory Hillandale Hospital are premiere providers of CT scan in Atlanta. This test also is known as a CAT scan, computed axial tomography scan or a computed tomography scan. A computed tomography (CT) scan is an imaging method that uses X-rays to create cross-sectional pictures of the body.

A CT scan procedure involves the use of X-ray and a computer to produce multiple images of the inside of the body. The equipment has a camera that takes pictures of your body during the CT scan to capture images from various angles. These images are joined together in cross-sectional views of the area being studied and have greater detail than the images provided through a regular X-rays.

A CT scan has greater clarity than conventional X-ray. Bone, soft tissue, internal organs, and blood vessels are some of the area’s that can be studied using this test. A CT scan procedure rapidly creates detailed pictures of the body, including the brain, chest, spine and abdomen. A CT scan test may be used to:

  • Guide a surgeon to the right area during a biopsy
  • Identify masses and tumors, including cancer
  • Study blood vessels

A radiologist who is specially trained in reviewing your CT scan images will promptly analyze your images and provide a report to your physician about the findings of your CT scan procedure at Emory Decatur Hospital and Emory Hillandale Hospital. Your physician will share the results with you.

Preparing for your CT Scan

A CT scan is essentially painless and requires minimal preparation. Be sure to tell you doctors if you have any of the following conditions because they may increase your chances of having a reaction to the contrast or the CT scan.

    Any recent illness A history of heart or lung disease Asthma Diabetes Multiple Myeloma Sickle Cell Hypertension Kidney disease

You will be asked to lie on a narrow table that slides into the center of the CT scanner. Depending on your test, you may be asked to lie on your back, side or stomach. The scanner itself is donut-shaped and will rotate around your body while it takes the images. You will be asked to lie very still and may be asked to hold your breath for different lengths of time while the images are being taken.

The entire CT scan procedure will last approximately 10 to 15 minutes. You may return to your normal daily activities unless otherwise instructed.

Some CT scans require the use of a special dye or contrast material. There are two different types: oral and intravenous contrast. Some exams require both, while others only require one. The contrast material is used to highlight certain areas of the body and create a clearer image. The contrast also helps give the radiologist additional information when he or she is reading your exam.

Oral Contrast

If you are having an abdominal or pelvic CT scan, you may be given a special liquid to drink before your procedure. This liquid helps to coat the stomach, small bowel and colon.

Do not eat or drink anything for two hours prior to drinking the liquid. You should drink it two hours before your appointment. There are few, if any, side effects to the oral contrast although you may notice white stools for a couple of days following your scan. If you have allergies to barium products and/or have difficulty swallowing, talk with your physician before your CT scan.

Intravenous Contrast

Depending on the area of your body that is being scanned or the symptoms you are experiencing, some of your organs or blood vessels may need to be better viewed. If this is the case, an IV needle will be inserted into your arm or hand, and used to give you the contrast material. This is similar to what you may feel when getting your blood drawn. Images are sometimes taken both before and after you are given the contrast material.

The contrast can cause some patients to become nauseous. If you know you are having an intravenous contrast, you should not eat for four hours prior to your CT scan. Unless otherwise instructed, drink plenty of fluids following your exam to allow the contrast to pass out of your body through your kidneys.

CT Scan Scheduling and Directions

Your physician may contact DeKalb Medical to schedule your CT scan for you or you may be asked to schedule your own procedure. If you need to schedule your CT scan, call 404.501.SCHD. Please make sure you have your physician's order.

If your CT scan will be performed at the Diagnostic Imaging Center at Emory Decatur Hospital,

  • From North Decatur Road, enter the hospital campus via Wash Lively Road.
  • The Diagnostic Imaging Center is on the left.
  • Parking is on the left in front of the center and is free for all Imaging Center patients.

If your CT scan is being performed at Emory Hillandale Hospital, go to the hospital’s registration area.

  • Park in the hospital parking lot.
  • Proceed to the main entrance of the hospital.
  • Registration is directly on the right – you must register before proceeding to the Imaging Department.
  • When you have completed registration, a staff member will direct you to the Imaging Department for your CT scan.

Emory Decatur Hospital performs mammography-guided biopsy or stereotactic needle biopsy when abnormalities that can’t be felt (nonpalpable) are identified by a mammogram. The abnormality is generally located on a routine screening mammogram. Mammography-guided biopsies use large (core) or small (fine) needles to obtain samples of the abnormal breast tissue. The physician uses a mammogram image from several different angles to create a virtual three-dimensional (stereotactic) picture of the abnormal area. This picture is used to guide the needle to the biopsy site where the mammography-guided biopsy takes place.

Mammography-guided biopsy of the breast is performed when a mammogram shows a breast abnormality such as:

  • A suspicious solid mass.
  • Microcalcifications, a tiny cluster of small calcium deposits.
  • A distortion in the structure of the breast tissue.
  • An area of abnormal tissue change.
  • A new mass or area of calcium deposits is present at a previous surgery site.

Preparing for Mammography-Guided Biopsies

Emory Decatur Hospital performs mammography-guided or stereotactic needle biopsy when abnormalities that can’t be felt (non-palable) are identified by a mammogram. General anesthesia is not used for mammography-guided biopsies. Usually the physician will inject a local anesthetic at the needle insertion site to numb the area. You will feel a stinging sensation when this is done. The physician will wait until the area is numb before proceeding with the biopsy.

Your physician will use special imaging techniques to be able to see the abnormal spot.You will lie face down on a table with your breast suspended through an opening. Mammograms then are taken of the suspicious site. A computer is used to guide the needle to the site for sample removal. At this point, you should only feel a pressure sensation as the needle is guided to the biopsy site.

If the abnormality can be seen easily on ultrasound, the biopsy may be performed while you lie on your back and ultrasound imaging is used to see the abnormality.

After Your Mammography-Guided Biopsy

After the biopsy, you may experience pain or discomfort at the site and you may have mild bruising at the site. Because of this, your physician may suggest limiting your activities for 24 to 48 hours after your biopsy.

The samples are examined in the laboratory by a pathologist to determine if cancer cells are present. A detailed report from the lab will be sent to your physician, who will share the results with you.

Scheduling and Directions

Emory Decatur Hospital offers mammography-guided biopsy in Atlanta at our Diagnostic Breast Center.

Your physician will contact Emory Decatur Hospital to schedule your mammography-guided biopsy.

Your mammography-guided biopsy will be performed at the Diagnostic Breast Center, which is in the 2665 Professional Building on the Emory Decatur Hospital campus.

  • From North Decatur Road, enter the hospital campus via Wash Lively Road.
  • At road end, turn right.
  • At stop sign, turn left and park in the Visitor/Patient parking deck.
  • Use the “A” or “E” elevator or take the stairs to Level 1.
  • Cross the street and proceed to the front entrance of the 2665 Professional Building.
  • Upon entering the building you will see the Diagnostic Breast Center entrance on the left.

Having a magnetic resonance imaging scan, or MRI scan, in Atlanta at Emory Decatur hospital and Emory Hillandale Hospital is an effective way for your doctor to get information that helps him or her make a more accurate diagnosis of your condition. Unlike X-rays and computed tomographic or CT scans, which use radiation, an MRI scan uses powerful magnets and radio waves.

Because a very strong magnet is used in an MRI scan, if you have a pacemaker and other implanted device you may not be able to have this particular exam.

An MRI scan produces dozens and sometimes hundreds of images that can be viewed from many different angles. Single MRI images are called slices. They can be stored on a computer or printed out using film. A radiologist who is specially trained in reviewing your images will promptly provide a report to your physician about the findings of your MRI scan in Atlanta at Emory Decatur Hospital and Emory Hillandale Hospital. Your physician will share the results with you.

Magnetic Resonance Imaging in Georgia

Emory Decatur Hospital is among those hospitals that offer both traditional and open magnetic resonance imaging in Georgia. The wide-open MRI scanner in Atlanta at Emory Decatur Hospital and Emory Hillandale Hospital often is better for those people who are claustrophobic or have a fear of being closed in because the machine is not as close to your body as it is in a traditional MRI. Some patients benefit from taking a mild sedative prior to their MRI scan to help them relax for the test. Talk with your physician if you have any anxiety about your MRI scan in Atlanta.

Preparing for your MRI Scan

Your MRI-guided breast biopsy at Emory Decatur Hospital and Emory Hillandale Hospitall will be done as an outpatient procedure. Unless you are told otherwise, you may follow your regular daily routine and take medications as usual.

The procedure does require an injection of contrast into your bloodstream. The radiologist or technologist may ask if you have allergies of any kind, such as allergy to iodine or x-ray contrast material, drugs, food, the environment or asthma. However, the contrast material used for an MRI exam, called gadolinium, does not contain iodine and is less likely to cause side effects or an allergic reaction. The radiologist also should know if you have any serious health problems or if you have recently had surgery. Some conditions, such as severe kidney disease, may prevent you from being given contrast material for an MRI.

You will be asked to wear a gown during the exam. You will be awake during your biopsy and should have little or no discomfort. Most women report little or no pain and no scarring on the breast. Some women find that the major discomfort of the procedure is from lying on their stomach for the length of the procedure, which can be reduced by strategically placed cushions.

You must remain still while the biopsy is performed.

When you receive the local anesthetic to numb the skin, you will feel a slight pin prick from the needle. The area will become numb within a short time. You may feel some pressure when the biopsy needle is inserted. As tissue samples are taken, you will hear clicks from the sampling instrument.

After your MRI-Guided Biopsy

If you experience swelling and bruising following your biopsy, you may be instructed to take an over-the-counter, non-aspirin pain reliever and to use a cold pack. Cold packs are provided in the Breast Center. All breast biopsy pts are taken to the Breast Center for a low-compression mammogram to verify the placement of the marker. It is also to note the changes in the breast. Although temporary bruising is normal, you should contact your physician if you experience excessive swelling, bleeding, drainage, redness or heat in the breast. You should avoid strenuous activity for 24 hours after returning home, but then usually you can resume normal activities.

The samples are examined in the laboratory by a pathologist to determine if cancer cells are present. A detailed report from the lab will be sent to your physician, who will share the results with you.

Scheduling and Directions

Emory Decatur Hospital offers magnetic resonance imaging in Georgia at Emory Decatur Hospital and Emory Hillandale Hospital.

Your physician will contact Emory Decatur Hospital to schedule all MRI-guided biopsy tests for you.

All of your MRI-guided breast biopsies will be performed at Emory Decatur Hospital, go to the hospital’s central registration area.

  • From North Decatur Road, enter the hospital campus via Wash Lively Road.
  • At road end, turn right. (Note: If you are in a wheelchair or need to be dropped off at the entrance, turn left and proceed to the Central
  • Registration patient drop-off which is on the right just past the main hospital entrance. Your driver should then turn around and continue to the Visitor/Patient parking deck.)
  • At stop sign, turn left and park in the Visitor/Patient parking deck.
  • Take any elevator or stairs to the 3rd level.
  • Proceed to the Pedestrian Bridge to the hospital.
  • Take bridge straight ahead to the escalators.
  • Take escalators down one level.
  • Once off escalators, turn right and immediately left and follow the directions to the hospital main lobby.
  • Proceed past the hospital Gift Shop on your right.
  • Once in the main lobby, follow the hallway to Central Registration.
  • At the end of hallway, turn left.
  • Central Registration is on the right.

If your procedure is being performed at Emory Hillandale Hospital, go to the hospital’s registration area.

  • Park in the hospital parking lot.
  • Proceed to the main entrance of the hospital.
  • Registration is directly on the right – you must register before proceeding to the Imaging Department.
  • When you have completed registration, a staff member will direct you to the Imaging Department for your procedure.

Emory Decatur Hospital and Emory Hillandale Hospital offer ultrasound-guided biopsy which involves the removal of cells from a suspicious area within the body using a thin needle and hollow tube called a syringe. During ultrasound-guided biopsy, the physician passes a needle through the syringe into the area or organ being examined and uses it to remove the tissue or fluid sample. Ultrasound is used by the physician to guide the needle to the appropriate area. The sample of tissue or fluid then is evaluated in the laboratory to determine your diagnosis.

Biopsies can be performed using surgery if the suspicious area is near the skin’s surface or can be removed during surgery. If the suspected tumor is deeper in the body and cannot be seen or felt by the physician, he or she may decide to perform an ultrasound-guided biopsy.

The main advantage of an ultrasound-guided biopsy is that it does not require an incision, although there is a disadvantage in some cases when the needle may not be able to remove enough tissue for analysis.

Types of Ultrasound-Guided Biopsies

We offer several types of ultrasound-guided biopsies. The most common ultrasound-guided biopsies performed at Emory Decatur Hospital and Emory Hillandale Hospital are liver, thyroid, prostate and breast.

Liver Biopsy

An ultrasound-guided biopsy of the liver involves taking a sample of tissue from the liver for examination and is used to help diagnose many liver diseases. These types of ultrasound-guided biopsies are usually done to evaluate the extent of liver damage due to disease or toxic injury.

The procedure helps assess the stage (early, advanced) of liver disease and is especially important in hepatitis C infection because it may be used to assess the patient’s prognosis and the likelihood of responding to antiviral treatment. Liver biopsy also can help detect:

  • Cancer
  • Infections
  • The cause of abnormal levels of liver enzymes that have been found in blood tests
  • The cause of an unexplained liver enlargement
  • Abnormalities in liver tissues after other techniques have failed to yield clear results
Thyroid Biopsy

Among the types of ultrasound-guided biopsies performed at Emory Decatur Hospital and Emory Hillandale Hospital is a thyroid biopsy. An ultrasound-guided biopsy of the thyroid removes small pieces of thyroid tissue for microscopic examination. The thyroid is a butterfly-shaped endocrine gland at the base of the neck and in front of the trachea (windpipe). It produces thyroxine, a hormone that plays a very crucial role in regulating the body’s metabolism and controlling several vital functions, such as the heart beat, blood pressure and body temperature. The thyroid also regulates childhood growth and development.

A thyroid biopsy is usually ordered when a painless lump or a nodule is detected, either by the patient or by a doctor during a routine physical examination to determine the cause of the mass, growth or tumor in the thyroid gland. A biopsy is the only test that can accurately determine whether the lump is non-cancerous (benign) or cancerous (malignant).

Prostate Biopsy

One of our types of ultrasound-guided biopsies using the newest medical imaging technologies is an ultrasound probe for diagnostic testing of prostate disease. Ultrasound-guided biopsy of the prostate is a procedure that involves removing a small piece of prostate tissue for microscopic examination. One of the three male sex glands, the prostate gland lies just below the urinary bladder, in the area behind the penis and in front of the rectum. It secretes semen, the liquid portion of the ejaculate.

The urethra carries the urine from the urinary bladder and the semen from the sex glands to the outside of the body.

Ultrasound-guided biopsy of the prostate is performed by inserting a needle through the perineum (the area between the base of the penis and the rectum). Before the procedure is performed, the patient may be given a local anesthesia or sedative to help him relax.

Breast Biopsy

An ultrasound-guided biopsy of the breast involves removal of a sample of suspicious breast tissue for examination by a pathologist. This can be accomplished by withdrawing tissue through a needle.Ultrasound is used to guide needle placement for most lesions. The patient lies on her back or side. After the area is numbed, sterile gel is applied. The physician places a transducer, an instrument about the size of an electric shaver, over the skin. This produces an image from the reflection of sound waves. A special needle, either in a spring loaded or vacuum-assisted device, is used to obtain the tissue. The procedure is observed on a monitor as it is happening.

Ultrasound is used to guide needle placement for most lesions. The patient lies on her back or side. After the area is numbed, sterile gel is applied. The physician places a transducer, an instrument about the size of an electric shaver, over the skin. This produces an image from the reflection of sound waves. A special needle, either in a spring loaded or vacuum-assisted device, is used to obtain the tissue. The procedure is observed on a monitor as it is happening.

Preparation

Preparing for your Ultrasound-Guided Biopsy

Ultrasound-guided biopsy usually is done on an outpatient basis and in most cases you should plan to have someone drive you home after your biopsy. Be sure to ask your physician about any medications you are taking or any questions your might have about your biopsy.

Use these preparation and care instructions as a guide. After your specific biopsy, your nurse will give you any after-care instructions including any restrictions on activities. A detailed report from the radiologist and the lab will be sent to your physician, who will share the results with you.

Liver Biopsy Preparation and Care

Avoid taking any aspirin and ibuprofen for at least a week before your biopsy. Your physician will check your records for any other medications that may affect blood clotting. Two tests, a platelet count and a prothrombin time to assess how well your blood clots, are performed prior to your biopsy to determine whether there is an abnormally high risk of uncontrolled bleeding from the biopsy site. Limit food or drink for four to eight hours before your procedure.

After your liver biopsy, you will be asked to lie on your right side for one hour and then to rest quietly for three more hours. Your nurse will regularly check your vital signs. If there are no complications, you will be discharged but asked to stay within an hour’s travel distance from Emory Decatur Hospital and Emory Hillandale Hospital in case you have delayed bleeding.

Bed rest for a day is recommended, followed by a week of avoiding heavy work or strenuous exercise. You can immediately resume eating a normal diet. You can expect some mild soreness in the biopsy area after the anesthetic wears off.

Thyroid Biopsy Preparation and Care

Do not eat or drink anything after midnight the night before your test. Do not take any blood thinners or aspirin three days prior to your biopsy.

The needle used in fine needle aspiration is thin and the whole procedure feels like a quick injection. You should have no pain or tenderness at the site after the biopsy. In large needle biopsy, a stinging needle prick may be felt when the local anesthetic is injected. The site may be sore for a few hours and tender for a day or two after the test. You may resume your normal activities.

Prostate Biopsy Preparation and Care

Do not take any blood thinners and aspirin three days prior to your biopsy. Complete one Fleet enema one hour before your biopsy.

If you notice any signs of infection or experience any blood clotting after your biopsy, notify your doctor.

Breast Biopsy Preparation and Care

Do not take blood thinners or aspirin three days prior to your biopsy. If possible, wear a sport bra and loose fitting top to your procedure.

If you notice any signs of infection after your biopsy, notify your physician.

Scheduling and Directions

Your physician will contact DeKalb Medical to schedule all ultrasound-guided biopsy tests for you.

If your biopsy is at Emory Decatur Hospital, go to the hospital’s central registration area.

  • From North Decatur Road, enter the hospital campus via Wash Lively Road.
  • At road end, turn right. (Note: If you are in a wheelchair or need to be dropped off at the entrance, turn left and proceed to the Central Registration patient drop-off which is on the right just past the main hospital entrance. Your driver should then turn around and continue to the Visitor/Patient parking deck.)
  • At stop sign, turn left and park in the Visitor/Patient parking deck.
  • Take any elevator or stairs to the 3rd level.
  • Proceed to the Pedestrian Bridge to the hospital.
  • Take bridge straight ahead to the escalators.
  • Take escalators down one level.
  • Once off escalators, turn right and immediately left and follow the directions to the hospital main lobby.
  • Proceed past the hospital Gift Shop on your right.
  • Once in the main lobby, follow the hallway to Central Registration.
  • At the end of hallway, turn left.
  • Central Registration is on the right.

If you biopsy is in the Diagnostic Breast Center, you need to go to the 2665 Professional Building on Emory Decatur Hospital campus.

  • From North Decatur Road, enter the hospital campus via Wash Lively Road.
  • At road end, turn right.
  • At stop sign, turn left and park in the Visitor/Patient parking deck.
  • Use the “A” or “E” elevator or take the stairs to Level 1.
  • Cross the street and proceed to the front entrance of the 2665 Professional Building.
  • Upon entering the building you will see the Diagnostic Breast Center entrance on the left.

If your biopsy is being performed at Emory Hillandale Hospital, go to the hospital’s registration area.

  • Park in the hospital parking lot.Proceed to the main entrance of the hospital.
  • Registration is directly on the right – you must register before proceeding to the Imaging Department.
  • When you have completed registration, a staff member will direct you to the Imaging Department for your biopsy.

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