PTC Puncture Needle (Chiba Needle ) — The Fine-Needle Pioneer Of Interventional Radiology

The PTC puncture needle, commonly known in the international interventional community as the Chiba Needle (千叶针 / Percutaneous Transhepatic Cholangio(graphy) Needle), was originally developed and popularized by the Department of Radiology at Chiba University in Japan. It is a thin-walled, fine-gauge hollow needle most frequently used for Fine Needle Aspiration (FNA / FNAB)​ under imaging guidance.

Basic Structure & Materials

A standard Chiba needle consists of:

• Needle tube:​ Thin-walled seamless stainless steel tube (typically SUS304 or SUS316L), sometimes NiTi (Nitinol) for enhanced flexibility and MRI compatibility.
• Bevel tip:​ Precision-ground long bevel with a 25°–30° angle, optimized for cellular aspiration.
• Hub:​ Polypropylene (PP) or polycarbonate (PC) funnel-shaped handle for syringe attachment; may be Luer-lock or friction-fit.
• Stylet (optional):​ Some sets include a removable obturator to prevent tissue plugging during insertion.

• Common Specifications

• Length:​ 15 cm, 18 cm, 20 cm, 22 cm, 30 cm (20–22 cm standard for deep hepatic puncture).

Gauge (G):

18G ≈ 1.20 mm → PTCD exchange or large cyst drainage

20G ≈ 0.90 mm

21G ≈ 0.80 mm

22G ≈ 0.70 mm → Classic PTC first-pass & FNA

23G ≈ 0.64 mm → Superficial thyroid / lymph node FNA

• Bevel angle:​ Classically 25°, providing optimal cellular yield.

• Core Clinical Applications

• Percutaneous Transhepatic Cholangiography (PTC) & Drainage (PTCD/PTBD):​ Ultrasound or fluoroscopy-guided puncture of intrahepatic dilated bile ducts for contrast injection or wire exchange to place a drainage catheter.
• Image-Guided Fine Needle Aspiration Biopsy (FNAB):​ Thyroid, lymph node, breast, lung, liver, pancreas, retroperitoneal masses.
• Cyst / Abscess Aspiration & Sclerotherapy:​ Hepatorenal cysts, pancreatic pseudocysts, abdominal abscesses.
• Specialized Uses:​ Percutaneous portal vein puncture, seed implantation tract, intralesional drug injection.

Advantages vs. Core Biopsy Needles

Compared with large-bore Tru-Cut (core) needles, Chiba needles:

Cause significantly less trauma to liver parenchyma, bile ducts, and vessels

Lower incidence of bleeding, biliorrhea, pneumothorax

Ideal for fragile patients, small targets, or initial duct access

Limitation:​ Provides cytology (cells), not histology (architecture); may be supplemented by core needle biopsy (CNB) or coaxial technique when tissue architecture is required (e.g., lymphoma subtyping).

Precautions

Relative contraindication: uncorrected coagulopathy (INR >1.5, PLT < 50×10⁹/L)

Continuous image guidance mandatory to avoid penetrating posterior structures or pleura

Single-use only; never resterilize (risk of cross-infection & tip dulling)

Maintain gentle negative pressure during withdrawal; release before fully removing needle to avoid loss of specimen into syringe dead space

In summary, the PTC/Chiba needle​ is the "first needle" in interventional radiology, ultrasonography, HPB surgery, and endocrinology - understanding its construction and indications is foundational for safe image-guided puncture.