Skip to main content
An official website of the United States government
Email

Imaging Response Criteria for Clinical Trials

Imaging-based response criteria are constantly changing. Web searches may reveal currently used imaging guidelines and research protocols.

Solid Tumors

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.

RECIST v1.1 (2011)

Lymphoma

  • International Working Group (Cheson) Criteria: published in 2007, the Cheson criteria defines standardized response criteria for Hodgkin and non-Hodgkin 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.

Bone Tumors

Hepatic Tumors

qEASL (published in 2012): methods to assess response to transcatheter arterial chemoembolization using quantitative three-dimensional hepatic tumor volume and enhancement measurements were described.

Renal Cell Cancer

Revised Choi (published in 2014): the revised Choi criteria incorporate changes in both concurrent size and CT attenuation in patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib.

Prostate Cancer

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. The impact of prostate-specific membrane antigen (PSMA) PET on PCWG3 staging was explored retrospectively.

Brain Tumors

  • 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) 2.0: first 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
  • Response Assessment in Pediatric Neuro-oncology (RAPNO) in pediatric high-grade glioma

Brain Tumor Imaging Acquistion Guidelines

Pediatric Tumors

The International Neuroblastoma Risk Group (INRG) Clinical Staging System Task Force Report

  • Updated:

If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “Imaging Response Criteria for Clinical Trials was originally published by the National Cancer Institute.”

Email