This story happened to one of our very young patients. A 22-year-old girl came to TomoClinic, frightened by the diagnosis according to X-ray in her native clinic. She arrived at the center, accompanied by the same confused and upset parents. And although our specialists immediately reassured the whole family, explaining that lung cancer almost never happens at that age. The results of a special diagnostics put an end to the problem. The girl revealed an inflammatory process in the lungs that is not related to oncology, and treatment was prescribed.
The story ended happily without unnecessary surgical intervention only because the patient contacted us on time and she was examined. As a result we have clear answer to our question: is it cancer or not? Such diagnostics called transthoracic lung biopsy is carried out under the control of computed tomography and belongs to one of the most modern areas — interventional radiology.
What is a CT lung biopsy?
This is one of the newest diagnostic methods using computed tomography. It helps to determine a node or anomaly (mass) and take a tissue sample for examination under a microscope. The method is minimally invasive and does not require general anesthesia.
The diagnostics must be carried out if your doctor finds a suspicious area on an X-ray or CT scan. Only the result of histological analysis of the tissue will allow you to accurately determine what it is: a benign inflammatory node or so-called pseudotumor, for example a lung abscess or tuberculosis, primary tumor or metastasis. The treatment plan will depend on the result.
Why is it important to have a lung biopsy when an abnormal area is detected in the image?
The problem of such chest diseases as lungs and mediastinum is very acute throughout the world, not only in Ukraine. Lung cancer is consistently in the top five in terms of mortality, and among men it ranks first. The insidiousness of the disease lies in the fact that it can disguise itself as bronchitis, pneumonia, etc. And it is often found at a late stage. The scale of the disaster in our country is clearly underestimated. Therefore, be careful about yourself. The sooner cancer is detected, the higher the chances of treatment success.
What is the procedure for taking a biopsy under CT control?
A CT scanner is a box-shaped large machine with a hole and a short tunnel in the center. You will be lying on the diagnostic table, sliding into and out of this tunnel. Our experienced specialist interventional radiologist Oleg Goroshenko will insert a needle into the skin under the continuous control of CT navigation and will advance it into the lesion. You need to lie calmly, try not to talk and follow the doctor’s commands.
“I control the tip of the needle, the target (node or mass) and the critical organs that are very important not to touch. It can be possible due to scanning at every moment of time. I make the sampling of the material so that there are at least two samples — two or three are optimal for further research under a microscope. The huge advantage of CT scans is that I can instantly see a possible complication and take measures immediately to eliminate it. According to our patients’ reviews there are no expressed painful sensations. It is because local anesthesia works good” — explains Dr. Oleg Goroshenko. He told us how the transthoracic (targeted) biopsy procedure works.
How to prepare for a transthoracic biopsy?
You need to have a blood test done for the doctors to know about your normal clotting and make sure that there is no risk of bleeding. In addition, you need to undergo electrocardiography and CT with contrast. Why with contrast? Because the vessels are very clearly visible on the pictures, and the specialist will understand how to perform a biopsy safely so as not to hurt them. CT can be done in 2-3 weeks or immediately before the procedure.
You must tell your doctor about the drugs you are taking, including herbal supplements. Tell if you have an allergic reaction, especially to anesthesia. Your doctor may advise you to stop taking aspirin or another blood thinner for a short period of time before the procedure.
Also tell your doctor about recent illnesses or chronic illnesses, if you have any. If you have diabetes and you are taking insulin, you should talk with a specialist, because you may need to adjust your usual dose of insulin.
Women should always inform the doctor if pregnancy is likely. Some procedures using radiation methods are not performed during pregnancy, since irradiation can be harmful to the fetus.
What are the contraindications for transthoracic biopsy?
In case of impaired heart function (arrhythmia) you need to consult a cardiologist who will prescribe treatment. If the condition stabilizes after treatment, you can undergo a biopsy procedure.
Regarding this, Oleg Goroshenko noted: “We always tell our patients about the need for treatment if there is arrhythmia. This is especially important for people who come to us from other cities or villages, so that they do not have to go back because of the inability to carry out the procedure without first treating arrhythmia”.
What happens after the procedure?
You will lie for two or three hours and be in the clinic under the supervision of medical staff. A low-dose CT scan will be performed after that for the doctors to verify there are no complications. If everything is ok, you can go home. If there are any complications, doctors will take measures to eliminate them and, perhaps, you will stay at the clinic overnight.
What are the contraindications for transthoracic biopsy?
Low-traumatic (minimally invasive) procedure, which, unlike a surgical biopsy, does not require incisions and general anesthesia.
The highest accuracy and reliability of the method for the diagnosis of benign, malignant nodes and masses.
Minimal risk of complications
The procedure is usually painless, and its results are as high-precision as during a biopsy with the removal of a tissue sample by surgical method.
The recovery time is short and you can resume your normal activities soon.
Oleg Goroshenko: “Proper planning is of great importance: this is one of my most important tasks for the interventional radiologist. After all, a person breathes, all organs are in motion, and you need to very accurately get into the moving target. According to the results we can establish a diagnosis, determine the type of tumor if the process is malignant, and develop the right treatment plan in any case”.
It is important. A transthoracic biopsy under constant CT monitoring is a unique method for Ukraine in diagnosing diseases of the lungs and mediastinum. TomoClinic is one of the few oncology centers where this method is used widely and successfully. There are frequent cases when patients turned to us for help with the verdict “metastases in the lung”, and our specialists disprove a cancer diagnosis based on the results of a biopsy.
Who should I contact?
If you have any problems related to the diagnosis of lungs or mediastinal diseases, or if you have questions, call the numbers indicated on our website https://tomocenter.com.ua (the call is free from mobile and landlines in Ukraine).