When a lesion is detected on an imaging study and is not palpable, imaging guidance is often necessary for biopsy. Computed tomography (CT), ultrasound, and/or fluoroscopy can be used to guide a needle to the correct place and obtain a small piece of tissue at this location. For spine biopsies we often use fluoroscopy and for soft tissue lesions adjacent to the spine, face or skull base we often use CT guidance. For lesions more superficially in the soft tissues, ultrasound is usually the best option.
