系统免疫疗法在癌症领域取得了巨大进展。然而，存在一些挑战，可能限制其治疗实体瘤的功效。直接瘤内注射可以提高免疫疗法的治疗指数，同时克服与全身给药相关的许多障碍，包括肿瘤的有限生物利用度和潜在的全身安全性问题。然而，挑战仍然存在，包括缺乏标准化的给药方法、与有效药物输送相关的问题、后勤障碍以及这种给药模式特有的安全问题。本文回顾了将免疫治疗剂局部注射到肿瘤中的生物学原理。它还解决了安全有效实施的现有限制和实际考虑因素，并为优化物流和处理工作流程提供了建议。它还强调了放射科医生、介入放射科医生和医学物理学家在肿瘤内免疫治疗中在靶点选择、图像引导管理和反应评估方面发挥的关键作用。© RSNA，2024。

Systemic immunotherapies have led to tremendous progress across the cancer landscape. However, several challenges exist, potentially limiting their efficacy in the treatment of solid tumors. Direct intratumoral injection can increase the therapeutic index of immunotherapies while overcoming many of the barriers associated with systemic administration, including limited bioavailability to tumors and potential systemic safety concerns. However, challenges remain, including the lack of standardized approaches for administration, issues relating to effective drug delivery, logistical hurdles, and safety concerns specific to this mode of administration. This article reviews the biologic rationale for the localized injection of immunotherapeutic agents into tumors. It also addresses the existing limitations and practical considerations for safe and effective implementation and provide recommendations for optimizing logistics and treatment workflows. It also highlights the critical role that radiologists, interventional radiologists, and medical physicists play in intratumoral immunotherapy with respect to target selection, image-guided administration, and response assessment.© RSNA, 2024.