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Meerten, E.L.V. van; Gelderblom, H.; Bloem, J.L. (2010)

RECIST revised: implications for the radiologist. A review article on the modified RECIST guideline

Article / Letter to editor
The purpose of this review article is to familiarize radiologists with the recently revised Response Evaluation Criteria in Solid Tumours (RECIST), used in many anticancer drug trials to assess response and progression rate. The most important modifications are: a reduction in the maximum number of target lesions from ten to five, with a maximum of two per organ, with a longest diameter of at least 10 mm; in lymph nodes (LNs) the short axis rather than the long axis should be measured, with normal LN measuring < 10 mm, non-target LN a parts per thousand yen10 mm but < 15 mm and target LN a parts per thousand yen15 mm; osteolytic lesions with a soft tissue component and cystic tumours may serve as target lesions; an additional requirement for progressive disease (PD) of target lesions is not only a a parts per thousand yen20% increase in the sum of the longest diameter (SLD) from the nadir but also a a parts per thousand yen5 mm absolute increase in the SLD (the other response...Show moreThe purpose of this review article is to familiarize radiologists with the recently revised Response Evaluation Criteria in Solid Tumours (RECIST), used in many anticancer drug trials to assess response and progression rate. The most important modifications are: a reduction in the maximum number of target lesions from ten to five, with a maximum of two per organ, with a longest diameter of at least 10 mm; in lymph nodes (LNs) the short axis rather than the long axis should be measured, with normal LN measuring < 10 mm, non-target LN a parts per thousand yen10 mm but < 15 mm and target LN a parts per thousand yen15 mm; osteolytic lesions with a soft tissue component and cystic tumours may serve as target lesions; an additional requirement for progressive disease (PD) of target lesions is not only a a parts per thousand yen20% increase in the sum of the longest diameter (SLD) from the nadir but also a a parts per thousand yen5 mm absolute increase in the SLD (the other response categories of target lesion are unchanged); PD of non-target lesions can only be applied if the increase in non-target lesions is representative of change in overall tumour burden; detailed imaging guidelines. Alternative response criteria in patients with hepatocellular carcinoma and gastrointestinal stromal tumours are discussed.Show less
Review Guidelines Diagnostic imaging Drug evaluation Antitumour drugs RECIST malignant pleural mesothelioma cell lung-cancer metastatic colorectal-cancer response evaluation criteria solid tumors lymph-nodes intraobserver variability pulmonary nodules clinical-trial breast-cancer
All authors
Meerten, E.L.V. van; Gelderblom, H.; Bloem, J.L.
Date
2010-06-30
Journal
European Radiology
Volume
20
Issue
6
Pages
1456 - 1467