Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
Future Oncol. 2011 May;7(5):669-77. doi: 10.2217/fon.11.38.
Anatomical response assessment criteria have been in use for decades, with the WHO guidelines being replaced by Response Evaluation Criteria in Solid Tumors (RECIST), updated in 2009 to RECIST 1.1. These methods rely on a change in size of a tumor as the main response criteria, but newer cytostatic agents tend to target tumor function at a molecular level before changing the size of a lesion. Recent modifications, such as the Choi criteria, have improved assessment by taking into account density of tumor, but all of these criteria fail to utilize functional imaging parameters, which are becoming increasingly available, including perfusion CT, perfusion MRI, diffusion-weighted imaging, magnetic resonance spectroscopy, dynamic contrast-enhanced ultrasound and combined PET/computed tomography. Developments in these modalities and standardization of imaging acquisition will help to optimize the next set of response criteria, with inclusion of multiparametric, functional modalities, evaluating tumors at the same molecular level at which they are being targeted by therapeutic agents.
几十年来，解剖学反应评估标准一直在使用，世界卫生组织的指南已被实体瘤反应评估标准（RECIST）取代，该标准于 2009 年更新为 RECIST 1.1。这些方法依赖于肿瘤大小的变化作为主要的反应标准，但新型细胞抑制剂往往在改变病变大小之前针对肿瘤功能在分子水平上发挥作用。最近的一些修改，如 Choi 标准，通过考虑肿瘤密度来提高评估的准确性，但所有这些标准都未能利用功能成像参数，这些参数越来越普及，包括灌注 CT、灌注 MRI、扩散加权成像、磁共振波谱、动态对比增强超声和结合 PET/CT。这些模式的发展和成像采集的标准化将有助于优化下一组反应标准，包括多参数、功能模式，以与治疗药物针对肿瘤的分子水平相同的方式评估肿瘤。
