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.

EBUSガイド下シスプラチンで処理された全ての患者のデータを検討しました。フロリダ大学の施設内倫理委員会は、この研究（＃IRB201400823）を承認しました。すべてのデータは、プロスペクティブに収集し、遡及的に分析しました。下記の登録基準を使用してください。 1.患者の選択<ol><li>生検で確認された非小細胞肺癌（NSCLC）、または小細胞肺癌（SCLC）を有しており、病理学的に確認された再発を有する18から80歳の間で選択した患者。 6ヶ月以上肺門および縦隔構造に放射線の少なくとも50 GYを受けた患者を登録します。 EBUSおよび遠隔転移を介してアクセス可能な肺門、縦隔に限定再発した患者、および気管支周囲の構造（リンパ節、結節、および大衆）が挙げられます。 </li><li>学際的な胸部腫瘍学腫瘍ボードにすべてのそのような患者を提示し、中を進める上でのコンセンサスを得ますローカライズされた他の治療法の選択肢が不足しているためtratumoralシスプラチン。 EBUSガイド下ITCを続行するという決定は、機関胸部腫瘍学腫瘍ボードの共同勧告すべきです。 </li></ol> 2.気管支内超音波（EBUS）はシスプラチン注射を-guided <ol><li>柔軟な気管支鏡に超音波プローブを内蔵し、肺門、縦隔、およびITCのための気管支周囲構造のリアルタイム可視化を可能にした凸プローブEBUSを、使用してください。 </li><li>患者は手順の前に、少なくとも6時間、経口食品や流体控えることを確認してください。 </li><li>以前に発表された文献9、10に基づいて、セッションごとに40mgの最大用量での1mg / mLの濃度で水性シスプラチンソリューションを作成します。使用直前に、0.9％NaCl溶液中で凍結乾燥されたシスプラチン粉末を溶解します。 </li><li>開始で静脈内デキサメタゾンを10mgおよびオンダンセトロンの8 mgを得吐き気を防止するための手順の寧。 </li><li>静脈内ミダゾラムとフェンタニル（IV）を使用して、意識下鎮静を使用して手順を実行します。手続きの前に4％のリドカイン噴霧の5ミリリットルの形で局所麻酔を使用してください。 </li><li>ミダゾラム2mgのフェンタニル50μgののIV注射から始めます。 、患者ごとに1〜2分を再評価し、追加1mgのミダゾラムと意識下鎮静を達成し、維持するために、25μgのフェンタニルボーラス（患者が継続的かつ独立して特許気道を維持することができるように、最小限に落ち込ん意識を与え、保護反射を保持そして、口頭コマンドや物理的刺激）に応答残ります。それぞれ、フェンタニルおよびミダゾラム、200μgのおよび10mgの最大許容用量を超えないようにしてください。 </li><li>心拍数を監視し、連続3誘導心電図、連続パルスオキシメトリー、および呼吸数の測定を含む、標準的な監視を使用してください。ローカルANESTを提供hesia、必要に応じて補足O 2。 </li><li>気道における声帯を通ってスコープを進めます。特定し、標的病変を見つけます。 </li><li> EBUSプロセッサの電源をオンにし、通常の生理食塩水の1-2ミリリットルを使用してスコープの先端にバルーンを膨らませます。気道壁全体に範囲をFlexおよび病変を見つけます。病変の位置は、CT / PET所見に依存するが、一般的なサイトのいくつかはsubcarinalエリア、左右の傍気管エリア、左右の肺門領域を含みます。 </li><li>スコープの作業チャネルを通ってシース内に収容されている22 G EBUS針を配備し、所定の位置にロックします。 注：注射部位には正確な外科的座標はありませんが、一般的に処理されたサイトのいくつかは、単にsubcarinal（内側左右の主気管支の接合部で）、（横方向に右主気管支に右傍気管を含み、右上葉オリフィス上記）、左傍気管、（大動脈弓と左肺動脈間の遠位気管と左主の接合部で）（横方向近位気管支intermediusので、右上葉の開口部の下）、右肺門、左肺門（で左上葉の接合部と左下葉気管支）。 </li><li>リアルタイム超音波ガイド下では、気管支壁を穿刺し、標的病変に針を配置します。針内にスタイレットを取り外し、一度に病変10ミリリットル（シスプラチンのを1mg / mL）にシスプラチンを注入します。シート内針を撤回。 </li><li>全体で薬の注入を容易にするために、異なる場所でのセッションごとに4つのパンクで各病変を治療します。穿刺あたりシスプラチン10mgを注入します。 </li><li>セッションごとに2つの病変に1を扱います。複数の病変はセッションごとに処理されている場合は、セッション当たりの総投与量は40ミリグラムを超えないと、シスプラチン20mgので各サイトを注入します。 </li><li> workiから針を外しますスコープのngのチャンネル。 </li><li>遠位気道からの追加の薬物を吸引し、気管支鏡を削除します。 </li><li>患者が病院のプロトコルどおりに回復し、同じ日にそれらを排出することができます。 </li><li> 4週間（1日目に、8、15、および22）の合計のために週に一度（2.7から2.13ステップ）シスプラチン注射を繰り返します。 注：処理された後は、特定の病変は、その後の出会いにITCでの再治療のために考慮すべきではありません。 </li></ol> 3.ポスト噴射<ol><li>フォローアップ胸部コンピュータ断層撮影法（CT）やポジトロン放出断層撮影（PET / CT）の応答を評価するには、8-12週間最後の治療セッションの後のスキャン。治療部位の再発および縦隔、肺門で再発、または鎖骨上窩などの局所再発として局所再発を定義します。 </li></ol>

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The authors have nothing to disclose.

<html>私たちの原稿は、より多くの放射線がオプションではありません人の患者のための肺癌の孤立した縦隔および肺門再発の管理に焦点を当てています。 IMHRの発生率は約9〜11％です。別の治療法の選択肢は緩和的化学療法、より多くの外部ビーム放射線療法、または支持療法および監視を含め、これらの患者に試みられてきました。当院では、我々は気管支鏡検査によっ?...

肺癌は、男性と女性の両方で世界的に最も一般的な癌であり、すべての癌関連死の5で1を占めています。それは0.87 1、2の場合の致死率を持っています。初期治療後の再発は肺癌患者の中で最も死亡を占めます。再発性肺癌の治療の選択肢は限られています。再発肺癌はまた、生活の質に有意な介護者のバーンアウトに重大な障害につながり、さらなる介入3に受け入れと寛容の可能性を減少させるそのすべてが、追加の支持療法を必要とします。 NSCLC患者の約30％は、放射線4の後に局所領域での再発を持っています。これらの患者のための治療の選択肢は限られており、わずか10％5、6の客観的な応答速度を有する全身化学療法が含まれます。繰り返し胸部放射が実現可能であるが、緩和を目的と症状緩和のために主に研究されており、疾患の寛解3のために使用されていません。 当院では、気管支鏡を介してアクセス可能な気管支内超音波（EBUS）で処理した孤立した縦隔および肺門再発（IMHR）を持つすべての患者は、シスプラチンの経気管支腫瘍内注射（ITC）を-guided。全身化学療法および/または外部ビーム放射線療法（EBRT）との併用療法は、治療専門医「裁量に従ってせました。本稿では、安全性、有効性、実現可能性、および当社の機関で使用されるプロトコルの詳細な方法を強調しています。

<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

肺癌患者における外照射療法（EBRT）以下の単離された肺門および縦隔再発（IMHR）が一般的です。これらの患者は、多くの治療の選択肢を持っていないと、通常は緩和的化学療法や対症療法を提供しています。気管支内超音波（EBUS）シスプラチンの腫瘍内注射を-guided（ITC）は、これらの患者のための新規なアプローチです。手順は、意識鎮静下で行われます。病変は、EBUSを使用して気管支鏡検査で配置され、22ゲージのEBUS針は、スコープの作業チャネルを通って前進し、位置にロックされます。超音波ガイド下では、気管気管支樹の壁が穿刺されると、針が標的病変に移動されます。針スタイレットを除去するとシスプラチン（40ミリグラム/ 40 mL）を病変部に注入されます。 1〜2サイトは、セッションごとに処理されます。手順の詳細は、紙のプロトコルの項に記載されています。当センターでは、50サイトが36人の患者に治療を受けました（19人の男性、17人の女性）。私たちのコホートの平均年齢は61.9±8.5歳でした。私たちは、35人の患者と41のサイト上で、最終的な分析を行いました。 11/35（31％）が安定または進行性疾患（非応答者）を有していたのに対し、24/35（69％）は、完全または部分的なレスポンス（応答）を有していました。全体的に、私たちのグループの生存率はしませんでしたものよりも有意に良好な生存率を持つ回答患者と8ヶ月（6-11カ月の95％CI）でした。

応答は、8-12週間治療後のフォローアップイメージングによって測定しました。応答は、完全寛解（CR）、部分寛解（PR）、安定な疾患（SD）、進行性疾患（PD）、またはRECIST 1.1基準8に基づいて応答を評価することができないとして分類されました。 CRとPRを有する患者はレスポンダーとみなされ、他は非応答者として分類しました。副次的転帰は、腫...

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.

肺癌の単離された縦隔再発の治療のためのシスプラチンの気管支内超音波ガイド下腫瘍内注射

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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10.4K ビュー.  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. 

ビデオ: 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.

PD L1 の発現を研究する同系の肺腺癌細胞の同所性同種移植

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

がん研究

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).

気管支超音波ガイド下経気管支穿刺吸引を使用して、胸骨下甲状腺生検

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.

挿管媒介気管内（IMIT）点眼：非侵襲的、肺特異的送達システム

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

モデル同所性NSCLCへの多細胞スフェロイドの肺内接種

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.

著者スポットライト:抗がん剤のナノ製剤開発のためのマウス非小細胞肺がんモデルの確立

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.

疾患進行を模倣し薬物活性を予測する非小細胞肺癌の同所性異種移植モデルの構築

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.

定位アブレーションボディ放射線治療のための動的肺腫瘍の追跡

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.

体幹部定位放射線照射のため内部のターゲット ボリュームによる肝転移の治療

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.

マウス肺内の選択的剤沈着を改善するための直接気管支内投与

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. ...

肺癌の単離された縦隔再発の治療のためのシスプラチンの気管支内超音波ガイド下腫瘍内注射

要約

さらに動画を探す

この動画の章

PD L1 の発現を研究する同系の肺腺癌細胞の同所性同種移植

気管支超音波ガイド下経気管支穿刺吸引を使用して、胸骨下甲状腺生検

挿管媒介気管内（IMIT）点眼：非侵襲的、肺特異的送達システム

疾患進行を模倣し薬物活性を予測する非小細胞肺癌の同所性異種移植モデルの構築

疾患進行を模倣し薬物活性を予測する非小細胞肺癌の同所性異種移植モデルの構築

疾患進行を模倣し薬物活性を予測する非小細胞肺癌の同所性異種移植モデルの構築

定位アブレーションボディ放射線治療のための動的肺腫瘍の追跡

体幹部定位放射線照射のため内部のターゲットボリュームによる肝転移の治療

マウス肺内の選択的剤沈着を改善するための直接気管支内投与

A Stepwise Approach for Performing Ultrasound Guided Transthoracic Lung Biopsy

肺癌の単離された縦隔再発の治療のためのシスプラチンの気管支内超音波ガイド下腫瘍内注射

要約

さらに動画を探す

この動画の章

PD L1 の発現を研究する同系の肺腺癌細胞の同所性同種移植

気管支超音波ガイド下経気管支穿刺吸引を使用して、胸骨下甲状腺生検

挿管媒介気管内（IMIT）点眼：非侵襲的、肺特異的送達システム

疾患進行を模倣し薬物活性を予測する非小細胞肺癌の同所性異種移植モデルの構築

疾患進行を模倣し薬物活性を予測する非小細胞肺癌の同所性異種移植モデルの構築

疾患進行を模倣し薬物活性を予測する非小細胞肺癌の同所性異種移植モデルの構築

定位アブレーションボディ放射線治療のための動的肺腫瘍の追跡

体幹部定位放射線照射のため内部のターゲット ボリュームによる肝転移の治療

マウス肺内の選択的剤沈着を改善するための直接気管支内投与

A Stepwise Approach for Performing Ultrasound Guided Transthoracic Lung Biopsy

体幹部定位放射線照射のため内部のターゲットボリュームによる肝転移の治療