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Table 2 Summary of major tumor response assessment criteria other than RECIST

From: Imaging biomarkers for evaluating tumor response: RECIST and beyond

Author / Year


Brief description

Hepatocellular carcinoma (HCC)

 Lencioni, R. et al. (2010) [16]

modified RECIST (mRECIST)

• To resolve limitations of anatomic tumor response metrics when applied RECIST 1.1 to molecular-targeted therapies or locoregional therapies in HCC.

• Reassessment of progression that could be misinterpreted in RECIST 1.1 due to the natural progression of chronic liver disease (ascites, enlargement of lymph nodes, etc.).

• Only well-delineated, arterially enhancing lesions can be selected as target lesions.

• Number of target lesions: up to 5 lesions (≤ 2 in any one organ).

• Short axis of porta hepatis lymph nodes ≥ 20 mm or other lymph nodes ≥ 15 mm are considered as malignant.

Brain tumor

 Macdonald, D.R. et al. (1990) [17]


• Using contrast-enhanced CT and MRI scans of the head.

• Response assessment is based on changes in tumor size (the product of the maximal cross-sectional enhancing diameters).

• Considering the use of corticosteroids and changes in the neurologic status of the patient.

 Wen, P.Y. et al. (2010) [18]


• Response Assessment in Neuro-Oncology (RANO) criteria.

• An update to the McDonald Criteria which also takes into consideration of non-enhancing tumor components, and lesions on the T1/T2-weighted and fluid-attenuated inversion recovery (FLAIR) MRI sequences.

• Definition of measurability.

• Number of target lesions: up to 5 lesions.

• Pseudo-progression considered.

Bone metastasis

 Hamaoka, T. et al. (2004) [19]


• MD Anderson (MDA) Bone Response Criteria.

• An approach for diagnosis and assessment of bone metastasis.

• Quantitative and qualitative assessments of the behavior of bone metastases based on x-ray, CT, and MRI.


 Cheson, B.D., et al. (2007) [20]

Revised Cheson

• Definition of standardized response criteria for Hodgkin’s and non-Hodgkin’s lymphoma using 18 F-FDG PET, immunohistochemistry, and flow cytometry.

 Cheson, B.D., et al. (2014) [21]


• Represent a set of revised recommendations regarding the use of the Cheson criteria and Deauville five-point scale, and formally incorporated 18 F-FDG PET into standard staging and response evaluation for FDG-avid lymphomas.

Gastrointestinal stromal tumor (GIST)

 Choi, H. et al. (2007) [22]


• CT criteria for evaluation of response to imatinib therapy in gastrointestinal stromal tumor (GIST).

• Combination of tumor size and tumor attenuation on CT (a 10 % decrease in tumor size or a more than 15 % decrease in tumor attenuation at 2 months of treatment) were used.

• Defining progressive disease by (1) appearance of new lesions, (2) appearance or increase in size of intratumoral nodules, or (3) tumor size increase by more than 20 % without post-treatment hypodense change.


 Young, H. et al. (1999) [23]

EORTC PET response

• European Organization for Research and Treatment of Cancer (EORTC) PET response.

• Proposed a common method of assessing tumor 18 F-FDG uptake and reporting of response data.

 Wahl, R.L. et al. (2009) [24]


• PET Response Criteria in Solid Tumors (PERCIST).

• Qualitative and quantitative approaches to metabolic tumor response assessment with 18 F-FDG PET.

 Goldfarb, L. et al. (2019) [25]


• Immune PET Response Criteria in Solid Tumors (iPERCIST).

• Monitoring anti-programmed cell death 1 (PD-1)-based immunotherapy in non-small cell lung cancer with 18 F-FDG PET.


 Wolchok, J.D. et al. (2009) [26]


• The immune-related Response Criteria (irRC)

• Bidimensional (the product of the maximal cross-sectional diameters).

• Selection of 5 lesions (≥ 5 × 5 mm) per organ (up to 10 visceral and 5 cutaneous ones).

• New lesions are incorporated into the total tumor burden, do not immediately mean progressive disease (PD).

 Nishino, M. et al. (2013) [27]


• The immune-related Response Evaluation Criteria in Solid Tumors (irRECIST) criteria.

• Unidimensional (longest diameter).

• Maximum 5 (2 per organ) lesions (≥ 10 mm in diameter; ≥15 mm for nodal lesions).

• New lesions are incorporated in the total measured tumor burden, do not immediately mean PD.

 Seymour, L. et al. (2017) [28]


• The immune Response Evaluation Criteria in Solid Tumors (iRECIST) criteria.

• Unidimensional (longest diameter).

• Maximum 5 (2 per organ) lesions (≥ 10 mm in diameter; ≥15 mm for nodal lesions).

• New lesions are recorded separately, not included in the sum of lesions for target lesions identified at baseline.

• Defining unconfirmed progressive disease (iUPD) and confirmed progressive disease (iCPD).

• iCPD: if additional new lesions appear or an increase in size of new lesions (≥ 5 mm for sum of new target lesion or any increase in new non-target lesion) on next cross-sectional imaging after iUPD.