Core Clinical Value And Comprehensive Application Landscape Of The Chiba Needle in Interventional Radiology

https://radiopaedia.org/articles/chiba-needle

The Chiba needle, also known as the Chiba biopsy needle or Chiba fine needle, originated from Chiba University in Japan and is one of the most representative fine needle aspiration biopsy (FNAB) tools in interventional radiology. Its typical specifications are 20G–25G, with 21G and 22G being the most commonly used. The outer diameter is approximately 0.6–0.9 mm, and the length is mostly 15–20 cm. The needle tip bevel angle is typically 25°, and its thin-walled, flexible design allows it to precisely reach deep-seated lesions under image guidance.

Core Clinical Applications

• Histological/Cytological Biopsy:​ Under CT or ultrasound guidance, fine needle aspiration is performed on pulmonary nodules, liver masses, pancreatic tumors, kidney tumors, and retroperitoneal lymph nodes to obtain cytological specimens. Literature reports that the cellular representativeness of CT-guided Chiba needle lung punctures exceeds 85%.
• Cyst Fluid/Abscess Aspiration and Drainage:​ Aspiration of hepatic cysts, renal cysts, pancreatic pseudocysts, and deep abscess contents for laboratory analysis or decompression therapy.
• Initial Puncture for Percutaneous Transhepatic Cholangiography (PTC) and Percutaneous Transhepatic Biliary Drainage (PTBD):​ A 21G or 22G Chiba needle is used for the first puncture into dilated intrahepatic bile ducts. After confirming bile return, a micro-guidewire is introduced to complete subsequent drainage catheter placement.
• Chemical Ablation and Drug Injection:​ Serves as a puncture and drug delivery channel in ethanol or pharmaceutical injection ablation therapies for liver cancer and metastatic lymph nodes.
• Nerve Blocks and Pain Interventions:​ Some centers use it as a drug infusion channel for discography and nerve root blocks.

Why the Chiba Needle Is Irreplaceable

Compared to coarse needles (such as Tru-Cut), the Chiba needle causes minimal trauma, with low incidences of pneumothorax and bleeding complications (the pneumothorax rate for lung puncture with 21–23G is approximately 5.1%, while 18G can reach nearly 50%). Its ultra-thin wall and large lumen-to-outer-diameter ratio facilitate negative-pressure aspiration of cells, and the moderately flexible needle body allows for fine directional adjustments in deep tissues - which is particularly critical for lesions adjacent to blood vessels or capsules.

Operational Key Points and Risk Control

Needle insertion must be performed under real-time ultrasound or CT monitoring, maintaining moderate negative pressure (gentle aspiration with a 5–10 mL syringe). After reaching the lesion, rotate and thrust 2–3 times, then release the negative pressure before withdrawing the needle. Contraindications include severe coagulation disorders, inability to cooperate with breath-holding, and no safe path avoiding major blood vessels or vital organs. Complications mainly consist of mild pneumothorax, needle tract bleeding, and minor bile leakage, most of which resolve spontaneously or with symptomatic treatment.

With the advancement of precision medicine, the Chiba needle has evolved from a mere "puncture tool" into a bridge connecting imaging diagnosis, cytopathology, and interventional therapy. It is an essential basic instrument in interventional departments, imaging departments, respiratory medicine, gastroenterology, and endocrinology (for thyroid nodule FNA).