Last Updated: 08/18/21
Imaging Response Criteria
Imaging based response criteria are constantly changing. Web searches may reveal currently used imaging guidelines and research protocols.
Response Evaluation Criteria in Solid Tumors (RECIST) — The current de facto standard for measuring response by imaging in oncology clinical trials, RECIST primarily uses anatomic change in lesion size for determining response to treatment. RECIST was developed by an expert panel of international experts and is validated using data from tens of thousands of cases.
Imaging-based response criteria for [18F]FDG-PET scans:
- PET Response Criteria in Solid Tumors (PERCIST): published in 2009, PERCIST is a comprehensive set of response criteria for use with [18F]FDG-PET scans
Imaging-based response criteria for brain tumor imaging:
- Macdonald Criteria — published in 1990 for use with contrast-enhanced CT and MRI scans of the head, response under the Macdonald Criteria is based on changes in tumor size and interpreted in light of steroid use and neurologic findings
- Response Assessment in Neuro-Oncology (RANO): published in 2010, RANO is an update to the Macdonald Criteria which also takes into consideration non-contrast enhancing components of the tumor and CT/MRI scans seen on the T2-weighted and FLAIR sequences.
- RANO — Brain Metastases: published in 2015, RANO-BM was developed by the RANO-BM Working Group as a standard response and progression criteria for use in clinical trials dealing with metastatic lesions to the brain
Imaging-based response criteria for lymphoma:
- International Working Group (Cheson) Criteria: published in 2007, the Cheson criteria defines standardized response criteria for Hodgkin’s and non-Hodgkin’s lymphoma using [18F]FDG PET, immunohistochemistry, and flow cytometry.
- Deauville Criteria: published in 2009, the Deauville Criteria describes a simplified 5 point scale to standardize interpretation of [18F]FDG PET scans in the setting of lymphoma
- Lugano Recommendations: published in 2014 as a result of a workshop at the 12th International Conference on Malignant Lymphoma, the Lugano Recommendations represent a set of revised recommendations regarding the use of the Cheson and Deauville Criteria and formally incorporated [18F]FDG PET into standard staging and response evaluation for FDG-avid lymphomas.
- At the current time, other response criteria such as LYRIC and RECIL are also useful for certain specific clinical indications.
Imaging-based response criteria for bone lesions:
- MD Anderson Bone Response Criteria (MDA): published in 2004, the MDA defines response in bone lesions based on anatomic imaging such as XR, CT, and MRI. Listed are newer related publications from MDACC.
- Prostate Cancer Working Group 3 (PCWG3): published in 2016, PCWG2 defines progression by imaging in prostate cancer but does not provide standardized definitions for treatment response by imaging
Other imaging-based response criteria:
- Revised Choi: published in 2014, the revised Choi criteria incorporates changes in both concurrent size and CT attenuation in patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib
- Response evaluation criteria in lymphoma (RECIL 2017): published in 2017, RECIL was established to harmonize the 2007 lymphoma response criteria with RECIST
- Immune-related Response Evaluation Criteria In Solid Tumors (irRECIST criteria): published in 2013, irRECIST is a set of published rules that incorporates revised irRC using RECIST 1.1 recommendations for assessment of the effect of immunotherapeutic agents
- Modified RECIST 1.1 for immune-based therapeutics (termed iRECIST): published in 2017, iRECIST is a consensus guideline developed by the RECIST working group for the use of modified Response Evaluation Criteria in Solid Tumours (RECIST version 1.1) in cancer immunotherapy trials