Bone Marrow Biopsy
A bone marrow biopsy is a minimally invasive procedure in which a small sample of bone marrow is retrieved with a needle, usually from the pelvis. Bone marrow is a soft material contained within the center of the bones that stores stem cells and is responsible for the creation of blood cells.
Why would I need a bone marrow biopsy?
A bone marrow biopsy can give your doctor a great deal of information about what’s going on in your body. If have bloodwork showing anemia or abnormal blood cell numbers, a bone marrow biopsy may be necessary to make a diagnosis. In some cases a biopsy may be done to monitor the progression or improvement of a known condition.
What is different about having a bone marrow biopsy performed by radiology compared to my doctor doing the procedure in office?
The bone marrow biopsy can often times be performed by a clinician in the office by palpating the area of the pelvic bone as he or she guides the needle into place. Sometimes though it can be a challenge to do this due to differences in your anatomy, and it may be necessary to use imaging to perform the procedure safely. Radiology clinicians can do this with precision using images obtained by a CT scanner.
Another reason you may be sent to interventional radiology for your biopsy is so that sedation can be given. Even though this is a straightforward and safe procedure, many patients understandably feel nervous when undergoing a bone marrow biopsy. Our nurses and clinicians are specially trained so that we can give medication through your IV to help you relax during the procedure. This is called conscious sedation, or what is often referred to as “twilight” sedation.
What should I expect when I come to have my bone marrow biopsy?
- When you arrive, a nurse will have you change into a hospital gown and complete the pre-procedural safety checks, including having blood drawn for routine labs if needed. In order to give ample time to complete these steps, we will ask you to arrive two hours before your scheduled procedure time.
- The procedural nurses will then bring you to the CT area and have you lie facing down on the CT table. After a timeout is performed, you will be given the sedation medication through the IV.
- The interventional radiology specialist will clean your skin and protect the area with sterile covering. He or she will give you lidocaine local anesthetic at the site. You can expect to feel a pinch and a sting when the lidocaine is given but this will go away when the skin goes numb after about thirty seconds.
- The CT scanner is used to image the area as the biopsy needle is guided into place. The bone marrow sample is obtained and given to a lab staff member, who processes the sample and ensures the quality is adequate for the necessary testing.
- After a bandage is placed at the site, you are transported back to the recovery area. You will be observed while the sedation medication wears off and your vital signs are monitored. This is typically about an hour but in some cases may be longer.
Frequently Asked Questions about Bone Marrow Biopsies
While not 100% painless, a bone marrow biopsy in interventional radiology is very well tolerated. In most cases we are able to give you sedation medication through your IV which will help you to relax. When the local anesthetic is given you can expect to feel some mild burning at the site for about thirty seconds, after which you will be numb. This will take away any sharp pain as the biopsy is performed. You may also feel some dull pressure in your pelvis briefly while the sample is aspirated from the bone, but this will only last ten seconds or less.
After the biopsy, you may have some soreness at the site for the 24 hours but this is typically mild and most patients do not even need to take pain medication for this.
A bone marrow biopsy is a safe procedure, especially with CT imaging guidance (which allows us to place the needle precisely and avoid critical structures).
Mild bleeding at the site is the most common complication, but typically affects less than 1% of patients and does not require any specific treatment. Major complications are practically unheard of in studies that reviewed a large number of biopsies.
We recommend that you take it easy for the rest of the day after your biopsy, avoiding any strenuous activity. If you do experience soreness at the site an ice pack can be applied.
You can usually resume your normal activities the day after the procedure, but you should listen to your body and avoid anything that causes pain.
The initial results of the biopsy are typically available to you and your doctor after approximately 3-5 business days. Some of the testing takes longer and it may be up to two weeks for all of the results to be complete.