Name: endobronchial ultrasound-guided intratumoral injection of cisplatin for the treatment of isolated mediastinal recurrence of lung cancer
Uploaded: 2017-02-12T14:00:00.000+00:00
Duration: 4 min 4 s
Description: Watch this Scientific Journal Video about Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer at JoVE.com

The authors have no acknowledgements.

与EBUS引导顺铂治疗所有患者的数据进行了审查。在佛罗里达大学的机构审查委员会批准了这项研究（＃IRB201400823）。所有数据收集前瞻性和回顾性分析。使用下面的入选标准。 1.病人选择<ol><li>谁拥有活检证实的非小细胞肺癌（NSCLC）或小细胞肺癌（SCLC），并有病理确诊复发的18和80岁之间的患者选择。报名谁收到至少50 GY辐射到肺门和纵隔结构为6个月或更长的患者。包括复发患者仅限于肺门，纵膈，支气管周围和结构（淋巴结肿大，结节，群众）通过EBUS和远处转移访问。 </li><li>目前所有此类病人多学科胸部肿瘤肿瘤委员会以及与在继续取得共识tratumoral顺铂由于缺乏其它局部治疗选择。着手EBUS引导ITC的决定应该是制度性胸腔肿瘤肿瘤委员会的联合推荐。 </li></ol> 2.支气管超声（EBUS）引导下顺铂注射液<ol><li>使用凸探针EBUS，其具有肺门，纵隔和ITC支气管周围结构的一个内置的超声波探头上的柔性支气管镜，使实时可视化。 </li><li>确保患者口腔的食物和液体弃权事先的程序至少6小时。 </li><li>创建在1毫克/毫升的带的每个会话40毫克最大剂量的浓度的含水氯氨铂溶液，根据先前发表的文献9,10。刚好在使用前溶解在0.9％NaCl溶液冻干氯氨铂细粉。 </li><li>给予地塞米松10mg和8毫克的恩丹西酮静脉注射的开始程序的宁以防止恶心。 </li><li>使用咪唑安定和静脉注射芬太尼进行清醒镇静的程序（IV）。在5mL之前的步骤4％利多卡因雾化的形式使用局部麻醉。 </li><li>与2毫克咪达唑仑和芬太尼50微克的静脉注射开始了。重新评估患者每1-2分钟，并得到额外的1毫克咪达唑仑和25微克芬太尼以实现和保持清醒镇静（一个最小压下意识使得患者能够连续地和独立地保持气道通畅，保留保护性反射，并保持响应口头命令和物理刺激）。不要超过最大允许剂量的芬太尼和咪达唑仑，200微克和10毫克，分别。 </li><li>使用标准的监测，包括连续3导联心电图监测心脏率，连续脉搏血氧饱和度，呼吸频率测量。提供本地ANESThesia并根据需要补充氧气 。 </li><li>通过在呼吸道声带前进的范围。识别和定位靶病变。 </li><li>打开EBUS处理器上，并在使用1-2毫升生理盐水的范围的末端充气气球。弯曲整个气道壁的范围和定位病灶。病变的位置将取决于CT / PET表现，但一些常见的部位的包括隆突区域，右侧和左侧气管区域，和左，右肺门区域。 </li><li>部署容纳在鞘通过范围的工作通道的22克EBUS针和在适当的位置锁定。 注意:虽然有对注射部位没有精确外科坐标，一些常用处理的部位的包括隆突（内侧在左和右主支气管的交界处），在右气管（横向在右主支气管，只是上面的右肺上叶口），左侧气管旁（在远端气管的接合处和主动脉弓和左肺动脉之间的左主），右肺门（横向在近端支气管中间型，右上叶开口下方），和左肺门（在左上叶交界处和左下叶支气管）。 </li><li>下实时超声引导，穿刺气管支气管壁和放置针在靶病变。针内移除管心针和注射顺铂进入病灶10毫升（1毫克/顺铂毫升）一次。缩回片内的针。 </li><li>对待每第四讲刺在不同的位置每个病变，以促进整个药物注射。注射10毫克每穿刺顺铂。 </li><li>治疗一到每个会话两支病变。如果一个以上的病变每个会话处理，注入每个站点与20mg顺铂，每会话不超过40毫克总剂量。 </li><li>从worki取出针范围的纳克通道。 </li><li>吸力从远端气道的任何其他药物并取出支气管镜。 </li><li>允许患者以恢复按照医院的协议和放电它们在同一天。 </li><li>重复顺铂注射（步骤2.7-2.13），每周一次，共4周（在天1，8，15，和22）。 注:一旦治疗，特定的损害不应该被视为在随后的遭遇与ITC复治。 </li></ol> 3.后喷射<ol><li>评估由后续胸部计算机断层扫描（CT）或正电子发射断层扫描（PET / CT）的响应中的最后一个疗程后8-12周进行扫描。定义局部复发于治疗部位复发和局部复发如纵隔，肺门复发，或锁骨上窝。 </li></ol>

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The authors have nothing to disclose.

<html>我们的手稿集中在肺癌纵隔孤立和肺门复发的管理病人谁更辐射是不是一种选择。 IMHR的发病率约为9％11。不同的治疗方案已经尝试在这些患者中，包括姑息性化疗，更多的外照射放疗，或支持治疗和监测。在我们的机构，我们将这些患者经纤支镜引导下肿瘤内顺铂。 出现了在肿瘤内化疗和免疫过去几年越来越感兴趣。之一的注入化疗剂进入肿瘤块的潜...

肺癌是所有癌症相关死亡的5男女双方，占全球1最常见的癌症。它有0.87 1，2病死率。初次治疗后复发占患者死亡人数最多肺癌。复发性肺癌的治疗选择是有限的。复发性肺癌也导致显著损害生活质量和护理人员显著倦怠并且需要额外的支持治疗，从而会降低接受和容忍的可能性进一步干预3。 NSCLC患者近30％有辐射4后局部复发。对这些患者的治疗选择是有限的，包括全身化疗，其具有仅10％的5，6的客观响应率。虽然重复胸部放疗是可行的，它已被主要研究姑息目的，缓解症状，并没有被用于疾病缓解3。 在我们的机构，孤立纵隔及肺门复发（IMHR）通过支气管镜访问的所有患者均与支气管内超声（EBUS）引导下治疗顺铂支气管内注射（ITC）。全身化疗和/或体外放射治疗（EBRT）并行处理被允许按照所述处理肿瘤学家"酌情。这份手稿突出了安全性，有效性，可行性，并在我们的机构所使用的协议的详细方法。

<table><tbody><tr><td>Bronchoscope</td><td></td><td></td><td></td></tr><tr><td>22 Guage olympus EBUS needle</td><td></td><td></td><td></td></tr><tr><td>40 g of cisplatin in 40 mL of normal saline</td><td></td><td></td><td></td></tr></tbody></table>

endobronchial ultrasound-guided intratumoral injection of cisplatin for the treatment of isolated mediastinal recurrence of lung cancer

患者孤立肺门以下体外放射治疗（EBRT）纵隔复发（IMHR）肺癌是常见的。这些患者没有太多的治疗方案，并且通常提供姑息性化疗或最佳支持治疗。支气管内超声（EBUS）引导下顺铂瘤内注射（ITC）是这些患者的新方法。该过程下清醒镇静进行。病变位于使用EBUS支气管镜，和22号针头EBUS通过范围的工作通道先进，锁定到位。在超声引导下，气管支气管树的壁被刺穿并且针移入目标病变。然后将针管心针被移除，顺铂（40毫克/ 40毫升）注射到病灶。一到两个站点每个会话处理。该过程的细节将在纸的协议部分中描述。在我们中心，50个站点中36例患者接受治疗（男性19例，女性17例）。我们的队列的平均年龄为61.9±8.5年。我们对35例患者和41位点进行最终的分析。 24/35（69％）有完全或部分响应（应答），而11/35（31％）具有稳定或进行性疾病（无应答）。总体而言，生存在我们组为8个月（6-11个月95％CI），与谁回答具有比谁没有的那些显著更好地生存的病人。

该反应是由后续成像治疗后8-12周进行测量。响应被列为完全缓解（CR），部分缓解（PR），稳定疾病（SD），进展性疾病（PD）或不能根据RECIST 1.1标准8来评估响应。与CR和PR患者被认为反应，和其他人被列为无反应。次要结果基于肿瘤组织学，复发的大小，和并发的全身治疗包括响应。也分析了协议的副作用和可行性。 <p class="jove_content" fo:keep-together.wit...

Watch this Scientific Journal Video about Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer at JoVE.com

Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer

The management of isolated recurrent lung cancer in a previously-irradiated field is challenging. Here, we describe an endobronchial ultrasound (EBUS)-guided cisplatin injection for the management of patients with localized lung cancer recurrence in a previously-radiated field.

支气管内超声引导下顺铂瘤内注射对肺癌纵隔孤立复发的治疗

Isolated hilar and mediastinal recurrence (IMHR) following external beam radiation therapy (EBRT) in patients with lung cancer is common. These patients ...

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Cancer Research

10.4K 次观看.  University of Florida College of Medicine. The management of isolated recurrent lung cancer in a previously-irradiated field is challenging. Here, we describe an endobronchial ultrasound (EBUS)-guided cisplatin injection for the management of patients with localized lung cancer recurrence in a previously-radiated field. 

视频: Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer

Orthotopic Transplantation of Syngeneic Lung Adenocarcinoma Cells to Study PD-L1 Expression

The use of mouse models is indispensable for studying the pathophysiology of various diseases. With respect to lung cancer, several models are available, including genetically engineered models as well as transplantation models. However, genetically engineered mouse models are time-consuming and expensive, whereas some orthotopic transplantation models are difficult to reproduce. Here, a non-invasive intratracheal delivery method of lung tumor cells as an alternative orthotopic transplantation model is described. The use of mouse lung adenocarcinoma cells and syngeneic graft recipients allows studying tumorigenesis under the presence of a fully active immune system. Furthermore, genetic manipulations of tumor cells before transplantation makes this model an attractive time-saving approach to study the impact of genetic factors on tumor growth and tumor cell gene expression profiles under physiological conditions. Using this model, we show that lung adenocarcinoma cells express increased levels of the T-cell suppressor programmed death-ligand 1 (PD-L1) when grown in their natural environment as compared to cultivation in vitro.

Here we describe a minimally invasive syngeneic orthotopic transplantation model of mouse lung adenocarcinoma cells as a time- and cost-reducing model to study non-small cell lung cancer.

合成肺腺癌细胞原位移植研究 pd-l1 表达

The use of mouse models is indispensable for studying the pathophysiology of various diseases. With respect to lung cancer, several models are available, ...

科研

癌症研究

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Substernal thyroid goiter (STG) represents about 5.8% of all mediastinal lesions1. There is a wide variation in the published incidence rates due to the lack of a standardized definition for STG. Biopsy is often required to differentiate benign from malignant lesions. Unlike cervical thyroid, the overlying sternum precludes ultrasound-guided percutaneous fine needle aspiration of STG. Consequently, surgical mediastinoscopy is performed in the majority of cases, causing significant procedure related morbidity and cost to healthcare. Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) is a frequently used procedure for diagnosis and staging of non-small cell lung cancer (NSCLC). Minimally invasive needle biopsy for lesions adjacent to the airways can be performed under real-time ultrasound guidance using EBUS. Its safety and efficacy is well established with over 90% sensitivity and specificity. The ability to perform EBUS as an outpatient procedure with same-day discharges offers distinct morbidity and financial advantages over surgery. As physicians performing EBUS gained procedural expertise, they have attempted to diversify its role in the diagnosis of non-lymph node thoracic pathologies. We propose here a role for EBUS-TBNA in the diagnosis of substernal thyroid lesions, along with a step-by-step protocol for the procedure.

Substernal thyroid lesions are common, and need to be differentiated from malignancy. Obtaining percutaneous fine needle biopsy is not possible due to its retrosternal location. This article proposes a protocol for biopsy of substernal thyroid lesions using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA).

胸骨后甲状腺活检使用支气管内超声引导下经支气管针吸

Substernal thyroid goiter (STG) represents about 5.8% of all mediastinal lesions1. There is a wide variation in the published incidence rates due to the ...

医学

Intubation-mediated Intratracheal (IMIT) Instillation: A Noninvasive, Lung-specific Delivery System

Respiratory disease studies typically involve the use of murine models as surrogate systems. However, there are significant physiologic differences between the murine and human respiratory systems, especially in their upper respiratory tracts (URT). In some models, these differences in the murine nasal cavity can have a significant impact on disease progression and presentation in the lower respiratory tract (LRT) when using intranasal instillation techniques, potentially limiting the usefulness of the mouse model to study these diseases. For these reasons, it would be advantageous to develop a technique to instill bacteria directly into the mouse lungs in order to study LRT disease in the absence of involvement of the URT. We have termed this lung specific delivery technique intubation-mediated intratracheal (IMIT) instillation. This noninvasive technique minimizes the potential for instillation into the bloodstream, which can occur during more invasive traditional surgical intratracheal infection approaches, and limits the possibility of incidental digestive tract delivery. IMIT is a two-step process in which mice are first intubated, with an intermediate step to ensure correct catheter placement into the trachea, followed by insertion of a blunt needle into the catheter to mediate direct delivery of bacteria into the lung. This approach facilitates a &#62;98% efficacy of delivery into the lungs with excellent distribution of reagent throughout the lung. Thus, IMIT represents a novel approach to study LRT disease and therapeutic delivery directly into the lung, improving upon the ability to use mice as surrogates to study human respiratory disease. Furthermore, the accuracy and reproducibility of this delivery system also makes it amenable to Good Laboratory Practice Standards (GLPS), as well as delivery of a wide range of reagents which require high efficiency delivery to the lung.

Intubation-mediated Intratracheal IMIT Instillation: A Noninvasive, Lung-specific Delivery System

Intubation-mediated intratracheal (IMIT) instillation of reagents is an excellent, noninvasive method for studying respiratory disease, as well as a method for instilling therapeutic reagents directly into the lung. It is a rapid and highly reproducible method which is suitable for preclinical testing.

插管介导气管内（IMIT）灌输:一种无创，龙专用输送系统

Respiratory disease studies typically involve the use of murine models as surrogate systems. However, there are significant physiologic differences ...

多细胞球体的肺内接种以模拟原位 NSCLC

Construction of An Orthotopic Xenograft Model of Non-Small Cell Lung Cancer Mimicking Disease Progression and Predicting Drug Activities

Non-small cell lung cancer (NSCLC) is a highly lethal disease with a complex and heterogeneous tumor microenvironment. Currently, common animal models based on subcutaneous inoculation of cancer cell suspensions do not recapitulate the tumor microenvironment in NSCLC. Herein we describe a murine orthotopic lung cancer xenograft model that employs the intrapulmonary inoculation of three-dimensional multicellular spheroids (MCS). Specifically, fluorescent human NSCLC cells (A549-iRFP) were cultured in low-attachment 96-well microplates with collagen for 3 weeks to form MCS, which were then inoculated intercostally into the left lung of athymic nude mice to establish the orthotopic lung cancer model.
Compared with the original A549 cell line, MCS of the A549-iRFP cell line responded similarly to anticancer drugs. The long-wavelength fluorescent signal of the A549-iRFP cells correlated strongly with common markers of cancer cell growth, including spheroid volume, cell viability, and cellular protein level, thus allowing dynamic monitoring of the cancer growth in vivo by fluorescent imaging. After inoculation into mice, the A549-iRFP MCS xenograft reliably progressed through phases closely resembling the clinical stages of NSCLC, including the expansion of the primary tumor, the emergence of neighboring secondary tumors, and the metastases of cancer cells to the contralateral right lung and remote organs. Moreover, the model responded to the benchmark antilung cancer drug, cisplatin with the anticipated toxicity and slower cancer progression. Therefore, this murine orthotopic xenograft model of NSCLC would serve as a platform to recapitulate the disease&#39;s progression and facilitate the development of potential anticancer drugs.

作者聚焦：建立小鼠非小细胞肺癌模型以开发抗癌药物纳米制剂

This study presents an orthotopic non-small cell lung cancer (NSCLC) model based on intrapulmonary inoculation of multicellular spheroids of fluorescent A549-iRFP cells. The model recapitulates clinical NSCLC stages and responds to cisplatin, according to dynamic in vivo monitoring of long-wavelength fluorescence.

模拟疾病进展和预测药物活性的非小细胞肺癌原位异种移植模型的构建

Non-small cell lung cancer (NSCLC) is a highly lethal disease with a complex and heterogeneous tumor microenvironment. Currently, common animal models ...

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Physicians considering stereotactic ablative body radiation therapy (SBRT) for the treatment of extracranial cancer targets must be aware of the sizeable risks for normal tissue injury and the hazards of physical tumor miss. A first-of-its-kind SBRT platform achieves high-precision ablative radiation treatment through a combination of versatile real-time imaging solutions and sophisticated tumor tracking capabilities. It uses dual-diagnostic kV x-ray units for stereoscopic open-loop feedback of cancer target intrafraction movement occurring as a consequence of respiratory motions and heartbeat. Image-guided feedback drives a gimbaled radiation accelerator (maximum 15 x 15 cm field size) capable of real-time &#177;4 cm pan-and-tilt action. Robot-driven &#177;60&#176; pivots of an integrated &#177;185&#176; rotational gantry allow for coplanar and non-coplanar accelerator beam set-up angles, ultimately permitting unique treatment degrees of freedom. State-of-the-art software aids real-time six dimensional positioning, ensuring irradiation of cancer targets with sub-millimeter accuracy (0.4 mm at isocenter). Use of these features enables treating physicians to steer radiation dose to cancer tumor targets while simultaneously reducing radiation dose to normal tissues. By adding respiration correlated computed tomography (CT) and 2-[18F] fluoro-2-deoxy-&#7429;-glucose (18F-FDG) positron emission tomography (PET) images into the planning system for enhanced tumor target contouring, the likelihood of physical tumor miss becomes substantially less1. In this article, we describe new radiation plans for the treatment of moving lung tumors.

Stereotactic ablative body radiation therapy (SBRT) involves the precise delivery of high-dose radiation to cancer tumor targets. A novel SBRT platform offers a first-of-its-kind gimbaled radiation accelerator mounted within a pivoting O-ring gantry capable of dynamic image-guided tumor tracking. Here, we describe dynamic tumor tracking for lung targets.

动态肺肿瘤跟踪烧蚀立体定向放射身体治疗

Physicians considering stereotactic ablative body radiation therapy (SBRT) for the treatment of extracranial cancer targets must be aware of the sizeable ...

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

The prognosis of patients with metastatic cancers has improved in the past decades due to effective chemotherapy and oligometastatic surgery. For inoperable patients, local ablation therapies, such as stereotactic body radiotherapy (SBRT), can provide effective local tumor control with minimal toxicity. Because of its high precision and accuracy, SBRT delivers a higher radiation dose per fraction, is more effective, and targets smaller irradiation volumes than does conventional radiotherapy. In addition, steep dose gradients from target lesions to surrounding normal tissues are achieved using SBRT; thus, SBRT provides more effective tumor control and exhibits fewer side effects than conventional radiotherapy. The use of SBRT is prevalent for treating intracranial lesions (known as stereotactic radiosurgery); however, it is now also used for treating spinal and adrenal metastases. Because of advancements in image-guided assistance and respiratory motion management, several studies have investigated the use of SBRT for treating lung or liver tumors, which move as a patient breathes. The results of these studies have suggested that SBRT favorably controls tumors in the case of moving lesions.
Four-dimensional computed tomography (4D-CT) with an abdominal compressor (AC) is clinically convenient for effective respiratory motion management. Because this method is noninvasive and allows free breathing, its use reduces complications. Furthermore, patients consider this method convenient. Moreover, it is considered more efficient than other methods of respiratory motion management by physicians and therapists. The use of 4D-CT with an AC for treating pulmonary lesions has also been widely investigated, and the technique is gaining acceptance for treating hepatic lesions. However, the protocols for using 4D-CT with an AC for treating hepatic lesions are different from those used for treating pulmonary lesions. In this article, we describe a new protocol for SBRT with 4D-CT and an AC for treating liver metastases.

Stereotactic body radiotherapy (SBRT) requires rigorous accuracy and precision for delivering high radiation doses per fraction to small treatment volumes to improve tumor control and simultaneously reduce toxicity. Herein, we present a noninvasive and clinically convenient respiratory motion management protocol for SBRT for liver metastases.

内靶容积法治疗肝转移瘤的立体定向体放疗

The prognosis of patients with metastatic cancers has improved in the past decades due to effective chemotherapy and oligometastatic surgery. For ...

Direct Intrabronchial Administration to Improve the Selective Agent Deposition Within the Mouse Lung

Intratracheal (IT) administration of experimental agents is an essential technique in murine models of diffuse lung diseases, such as bleomycin-induced pulmonary fibrosis.&#160; However, distribution of intratracheally-administered agents to the distal mouse lung is often asymmetric, with lung parenchymal concentrations increased in the smaller (but equally accessible) left lung of the mouse.&#160; Described in this report is a novel intrabronchial (IB) approach to cannulate the left and/or right lungs of living mice non-operatively.&#160; It is also demonstrated how this approach can be used to selectively administer agents to one lung or adapted (via dose-adjusted IB delivery) to improve the left-right symmetry of lung delivery of experimental agents, thereby improving models of diffuse lung disease such as bleomycin-induced pulmonary fibrosis.

Intratracheal (IT) administration of experimental agents in mice often results in asymmetric delivery to the distal lungs.&#160; In this report, we describe a direct intrabronchial (IB) approach to cannulate each lung in living mice non-operatively.&#160; This approach can be used to selectively administer agents to one lung or may be adapted to improve the symmetric agent delivery to both lungs.

直接注射内管理,改善小鼠肺内的选择性代理沉积

Intratracheal (IT) administration of experimental agents is an essential technique in murine models of diffuse lung diseases, such as bleomycin-induced ...

A Stepwise Approach for Performing Ultrasound Guided Transthoracic Lung Biopsy

Diagnosing patients with radiological lung lesions, especially those suspected of having primary lung cancer, is a common and critical clinical scenario. When selecting the most suitable invasive procedure to establish a diagnosis in these cases, a delicate balance must be struck between achieving a high diagnostic yield, providing staging information, minimizing potential complications, enhancing the patient experience, and controlling costs. The integration of thoracic ultrasound as a routine clinical tool in respiratory medicine has led to increased awareness and utilization of ultrasound-guided invasive techniques in chest procedures, including transthoracic biopsies. By following a systematic and stepwise approach, transthoracic ultrasound-guided lung biopsy emerges as a safe, cost-effective procedure with a remarkable diagnostic accuracy. These attributes collectively position it as an ideal invasive technique when technically feasible. Consequently, in patients presenting subpleural lung lesions suspected of malignancy, transthoracic ultrasound-guided lung biopsy has become a standard procedure in the realm of modern invasive pulmonology.

Transthoracic ultrasound-guided lung biopsy represents a safe, cost-effective, and efficient approach for patients presenting with subpleural lung lesions suspected of malignancy. Employing a systematic, step-by-step process is crucial to achieve optimal patient selection, minimize complication risks, and maximize diagnostic accuracy.

Diagnosing patients with radiological lung lesions, especially those suspected of having primary lung cancer, is a common and critical clinical scenario. ...

支气管内超声引导下顺铂瘤内注射对肺癌纵隔孤立复发的治疗

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合成肺腺癌细胞原位移植研究 pd-l1 表达

胸骨后甲状腺活检使用支气管内超声引导下经支气管针吸

插管介导气管内（IMIT）灌输:一种无创，龙专用输送系统

模拟疾病进展和预测药物活性的非小细胞肺癌原位异种移植模型的构建

模拟疾病进展和预测药物活性的非小细胞肺癌原位异种移植模型的构建

模拟疾病进展和预测药物活性的非小细胞肺癌原位异种移植模型的构建

动态肺肿瘤跟踪烧蚀立体定向放射身体治疗

内靶容积法治疗肝转移瘤的立体定向体放疗

直接注射内管理,改善小鼠肺内的选择性代理沉积

A Stepwise Approach for Performing Ultrasound Guided Transthoracic Lung Biopsy