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Biopsy
Your physician has referred you to Johns
Hopkins Neuroradiology so that we may take a sample of tissue from your head, neck or spine using image guidance.
The biopsy will be performed by a neuroradiologist,
a subspecialized doctor with training in performing and interpreting image
guided procedures including performing biopsies using CT guidance. The neuroradiologist will be assisted by a team of dedicated
health care professionals including radiology technologists and nurses. Our goal is to make you as comfortable as possible.
We welcome your questions, concerns, and comments, and are pleased to be able to offer this service to aid in your healthcare.
How to Prepare: A Checklist
You may call Mrs. Elnor Brown, administrative supervisor and biopsy coordinator, at (410) 614-3020 during business hours (8 am - 4:30 pm, Monday through Friday) with any questions.
If calling after hours please feel free to leave a message and you will receive a response the next business day.
Please notify us several days prior to your scheduled procedure if:
You are or might become pregnant.
You are allergic to lidocaine.
You are taking blood thinning medication such as: warfarin (Coumadin), Heparin, aspirin, clopidogrel (Plavix), or other platelet-inhibiting or blood thinning drugs.
Please notify the neuroradiologist, nurses and technologists the day of your procedure if:
Any of the above criteria apply to you.
(or)
You have a known allergy to latex.
Please take your medications as usual, unless told not to do so by your physician.
Take liquids as desired up to one hour prior to the time of your procedure. Take no
solid food within eight hours of your procedure. Refraining from eating prior to the procedure increases
the safety of sedation, should this be necessary in your case.
Do not bring jewelry or other valuables with you.
Arrange for someone to drive you home after the procedure.
What to bring:
1. If your physician has not already delivered all relevant imaging studies and reports to the neuroradiology department, please bring all applicable CT and MRI films and reports the day of your examination.
2. Bring information about existing conditions and medications.
3. Bring appropriate medical insurance materials.
4. If your physician has given you a request slip for the procedure please bring this as well.
Where to go the day of the procedure:
You may find directions to Johns Hopkins Hospital here.
During construction, parking is available in the McElderry garage adjacent to the outpatient center.
Please enter the Johns Hopkins outpatient center. After passing through security, proceed straight through the concourse
which leads to the main hospital building. Once in the main hospital building follow signs to Nelson Building (basement level). Take the elevator
down to level B1. The registration desk for neuroradiology is located just down the corridor to the left.
Please plan your travel to arrive at the hospital parking no later than 45 minutes prior to the scheduled time of your procedure.
What to Expect:
Prior to Your Procedure
When you arrive within the radiology department, you will be greeted by a member of our staff and
registered for your procedure. A physician will explain your procedure,
answer any questions, and have you sign a consent form. This discussion will include the options for sedation.
Most patients can undergo these procedures using local analgesia (numbing medication such as lidocaine) alone. However,
at your request you may receive intravenous sedation similar to valium. This requires placing an intravenous (IV) catheter in your
arm. Intravenous sedation will make you drowsy but you will not be completely asleep for the procedure.
If you do not request sedation in most circumstances you will not need an intravenous catheter.
You will be taken to the procedure
room, where you will lie in a position most advantageous for biopsy.
Most commonly biopsies are performed using a CT scanner, an x-ray device that looks like a large doughnut.
The skin over the region of the biopsy,
will be cleansed, and you will be partially covered a sterile drape.
During your Procedure
The neuroradiologist will give you local anesthetic which may cause slight discomfort for a few seconds before going numb.
A needle or biopsy device will be passed into the area of tissue to be sampled using imaging for guidance.
During this time, you may hear the whirring of the CT machine rapidly taking pictures.
You may feel pressure and minor discomfort in the area during the procedure. If you feel severe pain, we can give additional
medication to reduce it.
When the neuroradiologist has placed the biopsy device in the correct position small samples of tissue will be obtained for
analysis by the pathology department. It is important to remain still throughout the procedure. Please tell us if
you become uncomfortable.
After your Procedure
In general, biopsy procedures require as little as 30 minutes to complete, however depending upon the number of samples
taken and received by pathology, the procedure may take as long as 90 minutes.
You will be observed in the Neuroradiology area after the procedure. You may bring reading material or other items to pass the time.
Friends or family members may visit as desired. You will be discharged
by us when it is safe for you to leave, usually approximately 2 hours
after your study. Written instructions for home care will be provided.
After you Leave
You may resume your usual diet after the procedure.
Do not exert yourself for 24 hours following the procedure, after
which normal activity may be resumed. If you are an outpatient, a
family member or friend should drive you home and stay with you during
the 24-hour period.
It is not unusual to have minor bruising and discomfort around the biopsy site, but
if you experience bleeding or swelling of concern to you, please contact your referring physician immediately.
Do not use any blood thinning medication if you develop a hematoma at the biopsy site. Please contact your physician to discuss when
to resume blood thinning medication. If you experience
discomfort at the biopsy site, Tylenol or codeine may be used to control your symptoms.
Please contact us at any time if you have concerns.
Biopsy is Safe
Biopsy procedures are very safe. However, rarely one
may experience significant bleeding or damage to internal tissues or other unforseen issues. We will review these risks in detail
before your procedure. Because we must tell you every possible thing
that could go wrong during your biopsy, the list of risks is long.
Nonetheless, your doctor has felt that the benefit of the information
we obtain from this procedure outweighs the risks.
X-Rays
We are trained in the use of x-rays and every effort is taken to use
the minimum of radiation. The small amount of x-rays used during routine
biopsy will not be harmful to you. If you notice that the
staff wear leaded aprons, it is because they work with x-rays everyday
and their cumulative occupational exposure is high.
Additional Information
For additional
information on the web, we recommend you click on the link below to
visit the ACR and RSNA patient information site:
Billing and Insurance
If you are a self-pay patient, a bill will be issued at time of service
and mailed to your home.
If you are covered by a commercial health insurance carrier, please
bring your cards or proof of coverage should be brought with you the
day of your study. We will file your claim for you. If you are covered
by Blue Shield of Maryland Major Medical or Medicare Part B, we will
also file your claim for you. Please note that you will be billed
for any balance not covered by your plan. If you are covered by Maryland
Medical Assistance, we will verify your eligibility and bill them
directly. If you belong to a Health Maintenance Organization (HMO)
or Preferred Provider Organization (PPO) with which we have a contract,
you must bring the referral and authorization form for the procedure
to be covered.
If your visit is due to an accident (work-related, automobile, etc.),
you must provide us with an authorization from the guarantor of your
bill.
Note that separate bills are issued by the Johns Hopkins Hospital
(to cover facilities, equipment, and support personnel) and the Johns
Hopkins University School of Medicine (to cover the services of the
physician neuroradiologists). So expect to see two bills for your
study.
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