Published in:
01-11-2003 | Editorial
Can paediatric radiologists resist RECIST (Response Evaluation Criteria In Solid Tumours)?
Published in: Pediatric Radiology | Issue 11/2003
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The new Response Evaluation Criteria In Solid Tumours (RECIST) guidelines have been formulated to document tumour size change and monitor treatment response in oncological imaging [1]. From 1979, the World Health Organisation (WHO) handbook popularized four specific criteria for the codification of response evaluation in solid tumours (Table 1) [2]. These categories, namely complete response (CR), partial response (PR), stable disease (SD) (also termed "no change"), and progressive disease (PD) came to be used widely, both in adult and paediatric oncology practice. Four major problems with these definitions gradually became apparent:
Table 1.
RECIST criteria
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Complete response (CR)
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Disappearance of all (target and non-target) lesions—confirmed at 4 weeks
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Partial response (PR)
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At least 30% decrease in LD of single tumour or sum of LDs of multiple masses—confirmed at 4 weeks
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Stable disease (SD)
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Neither PR nor PD criteria met
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Progressive disease (PD)
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Greater than 20% increase in LD of single tumour or the sum of LDs in multiple masses, or appearance of new lesions
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1.
Methods of integrating the change in tumour size into response assessments varied between research groups.
2.
The minimum lesion size and number of lesions to be documented also varied.
3.
PD was based on the change in size of a single lesion by some authors and a change in the overall tumour load, including measurements of all lesions, by others.
4.
New technologies, particularly CT and MRI further complicated matters as regards the relevance of volumetric and three-dimensional measurements in response assessments [3].