Interventional procedures Flashcards
(26 cards)
needle gauge
-the smaller the gauge number the bigger the needle core (opening)/ the bigger the gauge number the smaller the needle core
cyst aspiration
-cystic lesions that have thick walls and other suspicious features
-symptom relief
-eliminate mammographic masses
-cytology fluid evaluated only if color is suspicious (if not, discarded in sharps container)
abscess drainage
-pt with an infection fluid collection that is not responding to antibiotic treatment (may have to be repeated)
fine needle aspiration (FNA)
-local anesthetic applied
-fine needle (18-25 gauge) used to aspirate cell
-cytotechnologist preps sample and places cell on a glass slide (multiple passes may be needed)
-U/S guided FNA done on irregular lymph nodes with thickened cortex
-yields CYTOLOGIC evaluation of CELLS
FNA advantages
-less invasive than core biopsy
-local anesthesia may be used
-safe, minimal complications
-usually on lymph nodes breast/axilla
-results in <1-2 hrs
FNA disadvantages
-possible false neg. b/c of small sample size
-cytologic eval doesn’t differentiate in situ from invasive cancers
-not used for sampling microcalcifications
Ultrasound core biopsy
-US guidance only
-solid lesions with other suspicious features
-lesions near chest wall
-pts with bleeding or clotting disorders where vacuum assistance may be contraindicated (not recommended)
US core biopsy technique
-14-16 gauge core biopsy needle in a spring loaded design with a trough
-3-5 passes (US used to guide)
core biopsy advantages
-less invasive than open surgical biopsy
-small incision and local anesthetic
-sample volume is sufficient for HISTOLOGIC (tissue) eval
core biopsy disadvantages
-risk of bleeding, infection or hematoma
-dense lesions are difficult to sample
-histologic analysis usually req. a min. of 24 hrs
vacuum-assisted core biopsy (VAAB
vacuum-assisted breast biopsy (VABB)
-Indications;
-solid lesions with other suspicious features should be biopsied
-7-14 gauge automated sampling system
-after local anesthesia, 1/4 in. skin incision made
-needle enters lesion once, sampling notch is rotated
-common type of image guided biopsy; stereotactic, US, MR, and Tomo
Vacuum assisted core biopsy stereotactic guidance used for what?
suspicious calcification
vacuum assisted core biopsy advantages
-less invasive than surgical bx, local anesthetic
-greater accuracy sampling dense masses
-vacuum assisted- one needle pass
-small lesions may be completely excised
-HISTOLOGIC (tissue) samples
-less cost
vacuum assisted core biopsy disadvantages
-greater risk of bleeding, infection, hematoma, or other complications
-healthy tissue may be compromised
clip placement
-can be placed after US, MR, stereotactic, or DBT breast biopsy
-safe, minimal complication
why do we do clip placement?
-necessary to place clip during biopsies in order to continue surveillance of the area on images on the pt in years following
-if area needs to be surgically removed, then clip will be removed too
post procedure imaging views to verify clip placement
-breast; CC, MLO
-axilla; AT, AP shoulder
wire localization (needle localization) indications
-placement of percutaneous needle wire for pre-operative guidance in locating;
-biopsy proven breast cancer or high-risk lesion
-non-palpable breast lesion
-wire guides surgeon to the mass (can be done w/ US or mammo)
post procedure mammogram
wire localization
-after wire localization, CC & ML or MLO are taken to assess wire placement
-following localization using a hook wire, pt is taken to surgery
-surgeon removes wire along with surrounding breast tissue
specimen radiography
-xray of specimen is taken to assure that the area of interest and/or clip is in the excised tissue
-specimen sent to pathology lab for examination and interpretation
seed placement
-wire free breast localization system
-size of a grain of rice
-non-radioactive; magseed SAVI SCOUT
-radioactive; I125 seed
post procedure imaging
verify seed placement
-breast; CC, ML
-axilla; AT, AP shoulder
OSHA
occupational safety and health administration created in 1970
biohazardous waste (medical waste)
waste that has risk of carrying infectious diseases (needles, glass, blades)
