{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T16:16:20Z","timestamp":1778775380076,"version":"3.51.4"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T00:00:00Z","timestamp":1670284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG2L0261"],"award-info":[{"award-number":["CMRPG2L0261"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CORPG3J0441"],"award-info":[{"award-number":["CORPG3J0441"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CRRPG2L0011"],"award-info":[{"award-number":["CRRPG2L0011"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>No reports on Letrozole as a pretreatment before ablation of uterine fibroid with high intensity focused ultrasound (HIFU), so a retrospective observation study was performed to evaluate the response of different pre-HIFU medication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected patients with single uterine fibroid receiving HIFU ablation from January 2018 to April 2021. All enrolled patients were classified into three group: group A (no pre-HIFU medication use), group B (Pre-HIFU letrozole use), group C (pre-HIFU gonadotrophin releasing hormone analog, GnRHa). Further associated clinical data and treatment response after HIFU treatment were reviewed and evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 39 patients including 21, 7, and 11 in group A, B, and C were collected respectively. After pre-HIFU medication, no difference of fibroid volume was found (A: 251.4, B: 360.6, C: 409.4 cm<jats:sup>3<\/jats:sup>, <jats:italic>p<\/jats:italic> = 0.250), and GnRHa group had significantly larger volume reduction than Letrozole users (38.6% vs. 16.4%, <jats:italic>p<\/jats:italic> = 0.007). The incidence of hypoestrogenic symptoms was higher in GnRHa group than in letrozole users (27.3% vs. 0, <jats:italic>p<\/jats:italic> = 0.170). GnRHa group had more sonication time (<jats:italic>p<\/jats:italic> = 0.001), treatment duration (<jats:italic>p<\/jats:italic> = 0.002), and ablated energy (<jats:italic>p<\/jats:italic> = 0.001) than group A and B. The treatment efficiency was higher in letrozole group than that in other 2 groups (4.52 vs. 2.39 vs. 2.34 cm<jats:sup>3<\/jats:sup>\/min, <jats:italic>p<\/jats:italic> = 0.050). For patients with fibroid over 10 cm in diameter, letrozole group had even better energy efficiency (<jats:italic>p<\/jats:italic> = 0.067), treatment speed (<jats:italic>p<\/jats:italic> = 0.007), treatment efficiency (<jats:italic>p<\/jats:italic> = 0.001), NPV per energy (<jats:italic>p<\/jats:italic> = 0.005), and NPV per sonication (<jats:italic>p<\/jats:italic> = 0.004) than other 2 groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Letrozole as a pretreatment medication before HIFU treatment might increase the energy efficiency and treatment efficiency of its ablation of uterine leiomyoma, especially for fibroid over 10 cm. Future study of larger patient number is needed to confirm our results.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.1069654","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T05:34:19Z","timestamp":1670304859000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Letrozole as premedication of high intensity focused ultrasound treatment of uterine fibroids: A retrospective observation study"],"prefix":"10.3389","volume":"9","author":[{"given":"Wei-Chun","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-Chen","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huei-Jean","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Jen","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting-Chang","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung-Hsueh","family":"Chou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1111\/1471-0528.14640","article-title":"Epidemiology of uterine fibroids: a systematic review","volume":"124","author":"Stewart","year":"2017","journal-title":"BJOG."},{"key":"B2","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/1472-6874-12-6","article-title":"Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women","volume":"12","author":"Zimmermann","year":"2012","journal-title":"BMC Womens Health."},{"key":"B3","doi-asserted-by":"publisher","first-page":"192","DOI":"10.5468\/ogs.2018.61.2.192","article-title":"Current medical treatment of uterine fibroids","volume":"61","author":"Sohn","year":"2018","journal-title":"Obstet Gynecol Sci."},{"key":"B4","first-page":"485","article-title":"Myo-inositol: from induction of ovulation to menopausal disorder management","volume":"67","author":"Gullo","year":"2015","journal-title":"Minerva Ginecol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1080\/09513590.2016.1254613","article-title":"Myo-inositol and melatonin in the menopausal transition","volume":"33","author":"D'anna","year":"2017","journal-title":"Gynecol Endocrinol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e932722","DOI":"10.12659\/AJCR.932722","article-title":"D-chiro-inositol induces ovulation in non-polycystic ovary syndrome (PCOS), non-insulin-resistant young women, likely by modulating aromatase expression: a report of 2 cases","volume":"22","author":"Bezerra Espinola MSLagan\u00e0 ASBilotta","year":"2021","journal-title":"Am J Case Rep."},{"key":"B7","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1024\/0300-9831\/a000691","article-title":"The role of vitamin D in metabolic and reproductive disturbances of polycystic ovary syndrome: a narrative mini-review","volume":"92","author":"Menichini","year":"2022","journal-title":"Int J Vitam Nutr Res."},{"key":"B8","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1002\/ijgo.13102","article-title":"Epidemiology and management of uterine fibroids","volume":"149","author":"Giuliani","year":"2020","journal-title":"Int J Gynaecol Obstet."},{"key":"B9","doi-asserted-by":"publisher","first-page":"274","DOI":"10.2214\/AJR.09.2842","article-title":"Leiomyoma shrinkage after MRI-guided focused ultrasound treatment: report of 80 patients","volume":"194","author":"Leblang","year":"2010","journal-title":"AJR Am J Roentgenol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/S0929-8266(99)00013-0","article-title":"Therapeutic ultrasound","volume":"9","author":"Ter","year":"1999","journal-title":"Eur J Ultrasound."},{"key":"B11","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1067\/S0002-9378(03)00664-1","article-title":"Tissue ablation using high-intensity focused ultrasound in the fetal sheep model: potential for fetal treatment","volume":"189","author":"Paek","year":"2003","journal-title":"Am J Obstet Gynecol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"477","DOI":"10.7863\/jum.2007.26.4.477","article-title":"Study of sequential histopathologic changes, apoptosis, and cell proliferation in rabbit livers after high-intensity focused ultrasound ablation","volume":"26","author":"Luo","year":"2007","journal-title":"J Ultrasound Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1038\/nrc3672","article-title":"Thermal ablation of tumours: biological mechanisms and advances in therapy","volume":"14","author":"Chu","year":"2014","journal-title":"Nat Rev Cancer."},{"key":"B14","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1172\/JCI1112","article-title":"Macrophages that have ingested apoptotic cells in vitro inhibit proinflammatory cytokine production through autocrine\/paracrine mechanisms involving TGF-beta, PGE2, and PAF","volume":"101","author":"Fadok","year":"1998","journal-title":"J Clin Invest."},{"key":"B15","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1002\/wnan.1168","article-title":"Visualization of inflammation using (19) F-magnetic resonance imaging and perfluorocarbons","volume":"4","author":"Stoll","year":"2012","journal-title":"Wiley Interdiscip Rev Nanomed Nanobiotechnol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1002\/wnan.1163","article-title":"19F magnetic resonance imaging of endogenous macrophages in inflammation","volume":"4","author":"Temme","year":"2012","journal-title":"Wiley interdiscip Rev Nanomed Nanobiotechnol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/1471-0528.14736","article-title":"Gonadotrophin-releasing hormone agonist combined with high-intensity focused ultrasound ablation for adenomyosis: a clinical study","volume":"3","author":"Guo","year":"2017","journal-title":"Bjog."},{"key":"B18","doi-asserted-by":"publisher","first-page":"20160760","DOI":"10.1259\/bjr.20160760","article-title":"Ultrasound guided high-intensity focused ultrasound combined with gonadotropin releasing hormone analogue (GnRHa) ablating uterine leiomyoma with homogeneous hyperintensity on T(2) weighted MR imaging","volume":"90","author":"Yang","year":"2017","journal-title":"Br J Radiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1080\/02656736.2018.1440014","article-title":"Effect of pre-treatment with gonadotropin-releasing hormone analogue GnRH-\u03b1 on high-intensity focussed ultrasound ablation for diffuse adenomyosis: a preliminary study","volume":"34","author":"Xiao-Ying","year":"2018","journal-title":"Int J Hyperthermia."},{"key":"B20","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1080\/02656736.2018.1509238","article-title":"High intensity focused ultrasound treatment of adenomyosis: a comparative study","volume":"35","author":"Guo","year":"2018","journal-title":"Int J Hyperthermia."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1080\/02656736.2019.1679892","article-title":"High-intensity focused ultrasound (HIFU) combined with gonadotropin-releasing hormone analogs (GnRHa) and levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis: a case series with long-term follow up","volume":"36","author":"Haiyan","year":"2019","journal-title":"Int J Hyperthermia."},{"key":"B22","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1196\/annals.1386.022","article-title":"Aromatase inhibitors: structural features and biochemical characterization","volume":"1089","author":"Hong","year":"2006","journal-title":"Ann N Y Acad Sci."},{"key":"B23","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1093\/humupd\/dmn033","article-title":"Use of letrozole in assisted reproduction: a systematic review and meta-analysis","volume":"14","author":"Requena","year":"2008","journal-title":"Hum Reprod Update."},{"key":"B24","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.bpobgyn.2015.11.015","article-title":"Hormones and pathogenesis of uterine fibroids","volume":"34","author":"Reis","year":"2016","journal-title":"Best Pract Res Clin Obstet Gynaecol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"676133","DOI":"10.3389\/fendo.2021.676133","article-title":"Letrozole for female infertility","volume":"12","author":"Yang","year":"2021","journal-title":"Front Endocrinol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1016\/S1472-6483(10)60246-5","article-title":"Treatment of symptomatic uterine leiomyoma with letrozole","volume":"17","author":"Gurates","year":"2008","journal-title":"Reprod Biomed Online."},{"key":"B27","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.ejogrb.2013.09.010","article-title":"Role of the aromatase inhibitor letrozole in the management of uterine leiomyomas in premenopausal women","volume":"171","author":"Duhan","year":"2013","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.fertnstert.2008.09.064","article-title":"A randomized, controlled clinical trial comparing the effects of aromatase inhibitor (letrozole) and gonadotropin-releasing hormone agonist (triptorelin) on uterine leiomyoma volume and hormonal status","volume":"93","author":"Parsanezhad","year":"2010","journal-title":"Fertil Steril."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.2147\/OTT.S81087","article-title":"Clinical utility of letrozole in the treatment of breast cancer: a Chinese perspective","volume":"9","author":"He","year":"2016","journal-title":"Onco Targets Ther."},{"key":"B30","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.ajog.2006.08.030","article-title":"Magnetic resonance-guided focused ultrasound surgery for uterine fibroids: relationship between the therapeutic effects and signal intensity of preexisting T2-weighted magnetic resonance images","volume":"196","author":"Funaki","year":"2007","journal-title":"Am J Obstet Gynecol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1002\/jmri.24998","article-title":"Comparison of the diagnostic accuracy of contrast-enhanced MRI and diffusion-weighted MRI in the differentiation between uterine leiomyosarcoma \/ smooth muscle tumor with uncertain malignant potential and benign leiomyoma","volume":"43","author":"Lin","year":"2016","journal-title":"J Magn Reson Imaging."},{"key":"B32","doi-asserted-by":"publisher","first-page":"S199","DOI":"10.1097\/01.RVI.0000094584.83406.3e","article-title":"Society of interventional radiology clinical practice guidelines","volume":"14","author":"Sacks","year":"2003","journal-title":"J Vasc Interv Radiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1148\/radiology.153.1.6473771","article-title":"Pelvic organs in premenarcheal girls: real-time ultrasonography","volume":"153","author":"Orsini","year":"1984","journal-title":"Radiology."},{"key":"B34","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.jmig.2013.09.004","article-title":"Ultrasound-guided high-intensity focused ultrasound vs laparoscopic myomectomy for symptomatic uterine myomas","volume":"21","author":"Wang","year":"2014","journal-title":"J Minim Invasive Gynecol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1111\/1471-0528.14689","article-title":"Evaluation of high-intensity focused ultrasound ablation for uterine fibroids: an IDEAL prospective exploration study","volume":"125","author":"Chen","year":"2018","journal-title":"BJOG Int J Obstet Gynaecol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"3214","DOI":"10.1016\/j.ultrasmedbio.2019.08.022","article-title":"Safety and efficacy of ultrasound-guided high-intensity focused ultrasound treatment for uterine fibroids and adenomyosis","volume":"45","author":"Lee","year":"2019","journal-title":"Ultrasound Med Biol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1080\/02656736.2018.1511837","article-title":"Factors affecting effects of ultrasound guided high intensity focused ultrasound for single uterine fibroids: a retrospective analysis","volume":"35","author":"Fan","year":"2018","journal-title":"Int J Hyperthermia."},{"key":"B38","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/j.ejrad.2014.11.041","article-title":"A retrospective comparison of microwave ablation and high intensity focused ultrasound for treating symptomatic uterine fibroids","volume":"84","author":"Zhao","year":"2015","journal-title":"Eur J Radiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/978-3-319-22536-4_1","article-title":"HIFU tissue ablation: concept and devices","volume":"880","author":"Ter","year":"2016","journal-title":"Adv Exp Med Biol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/S0301-5629(01)00515-4","article-title":"Tumor vessel destruction resulting from high-intensity focused ultrasound in patients with solid malignancies","volume":"28","author":"Wu","year":"2002","journal-title":"Ultrasound Med Biol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"R1240","DOI":"10.1152\/ajpregu.2000.278.5.R1240","article-title":"Hyperthermia impairs liver mitochondrial function in vitro","volume":"278","author":"Willis","year":"2000","journal-title":"Am J Physiol Regul Int Comp Physiol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1161\/CIRCULATIONAHA.116.025684","article-title":"The role of efferocytosis in atherosclerosis","volume":"135","author":"Kojima","year":"2017","journal-title":"Circulation."},{"key":"B43","doi-asserted-by":"publisher","first-page":"13062","DOI":"10.1038\/s41598-018-30106-4","article-title":"Chemo-immunotherapy of colon cancer with focused ultrasound and Salmonella-laden temperature sensitive liposomes (thermobots)","volume":"8","author":"Ektate","year":"2018","journal-title":"Sci Rep."},{"key":"B44","doi-asserted-by":"publisher","first-page":"3","DOI":"10.15746\/sms.15.022","article-title":"High intensity focused ultrasound treatment-induced tumor lysis syndrome in uterine myoma patient","volume":"21","author":"Park","year":"2015","journal-title":"Soonchunhyang Med Sci."},{"key":"B45","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.ejrad.2006.04.009","article-title":"Magnetic resonance guided focused ultrasound surgery of uterine fibroids\u2013the tissue effects of GnRH agonist pre-treatment","volume":"59","author":"Smart","year":"2006","journal-title":"Eur J Radiol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/S0169-409X(97)00050-1","article-title":"One- and three-month release injectable microspheres of the LH-RH superagonist leuprorelin acetate","volume":"28","author":"Okada","year":"1997","journal-title":"Adv Drug Deliv Rev."},{"key":"B47","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1007\/s11547-017-0754-6","article-title":"Efficacy of single-dose gonadotropin-releasing hormone agonist administration prior to magnetic resonance-guided focused ultrasound surgery for symptomatic uterine fibroids","volume":"122","author":"Park","year":"2017","journal-title":"Radiol Med."},{"key":"B48","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.3390\/jcm11051311","article-title":"Oncofertility and reproductive counseling in patients with breast cancer: A retrospective study","volume":"11","author":"Zaami","year":"2022","journal-title":"J Clin Med"},{"key":"B49","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.rbmo.2011.10.011","article-title":"Cryptic sperm defects may be the cause for total fertilization failure in oocyte donor cycles","volume":"24","author":"Goudakou","year":"2012","journal-title":"Reprod Biomed Online."},{"key":"B50","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1016\/j.fertnstert.2016.07.1066","article-title":"How does closed system vitrification of human oocytes affect the clinical outcome? A prospective, observational, cohort, noninferiority trial in an oocyte donation program","volume":"106","author":"Papatheodorou","year":"2016","journal-title":"Fertil Steril."},{"key":"B51","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.3390\/medicina58091218","article-title":"Neonatal outcomes and long-term follow-up of children born from frozen embryo, a narrative review of latest research findings","volume":"58","author":"Gullo","year":"2022","journal-title":"Medicina."},{"key":"B52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/01443615.2022.2109953","article-title":"Impact of assisted reproduction techniques on the neuro-psycho-motor outcome of newborns: a critical appraisal","author":"Gullo","year":"2022","journal-title":"J Obstet Gynaecol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1080\/13625187.2022.2045936","article-title":"Fertility preservation in female cancer sufferers: (only) a moral obligation?","volume":"27","author":"Zaami","year":"2022","journal-title":"Eur J Contracept Reprod Health Care."},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-031212","article-title":"Cross-talk between estrogen receptor and growth factor pathways as a molecular target for overcoming endocrine resistance","author":"Schiff","year":"2004","journal-title":"Clin Cancer Res 10 331s-336s."},{"key":"B55","first-page":"8037","article-title":"Signaling pathways of apoptosis activated by aromatase inhibitors and antiestrogens","volume":"63","author":"Thiantanawat","year":"2003","journal-title":"Cancer Res."},{"key":"B56","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.fertnstert.2005.01.137","article-title":"Effects of aromatase inhibitors on proliferation and apoptosis in eutopic endometrial cell cultures from patients with endometriosis","volume":"84","author":"Meresman","year":"2005","journal-title":"Fertil Steril."},{"key":"B57","doi-asserted-by":"publisher","first-page":"e41632","DOI":"10.1371\/journal.pone.0041632","article-title":"M-HIFU inhibits tumor growth, suppresses STAT3 activity and enhances tumor specific immunity in a transplant tumor model of prostate cancer","volume":"7","author":"Huang","year":"2012","journal-title":"PLoS ONE."},{"key":"B58","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/s12957-016-0908-3","article-title":"Damage effect of high-intensity focused ultrasound on breast cancer tissues and their vascularities","volume":"14","author":"Guan","year":"2016","journal-title":"World J Surg Oncol."},{"key":"B59","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1136\/jitc-2021-003717","article-title":"Combination of ultrasound-based mechanical disruption of tumor with immune checkpoint blockade modifies tumor microenvironment and augments systemic antitumor immunity","author":"Abe","year":"2022","journal-title":"J Immunother Cancer."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.1069654\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T05:34:23Z","timestamp":1670304863000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.1069654\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,6]]},"references-count":59,"alternative-id":["10.3389\/fmed.2022.1069654"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.1069654","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,6]]},"article-number":"1069654"}}