TABLE 4.
Main classifications used to assess tumor response after locoregional treatment
| Criteria | System | Response | Definition |
|---|---|---|---|
| Size | WHO | CR | Disappearance of all TL |
| PR | ≥ 50% decrease in CP of TL | ||
| SD | < 50% decrease to ≤25% increase in CP of TL | ||
| PD | > 25% increase from maximum response of TL | ||
| RECIST | CR | Disappearance of all TL | |
| PR | ≥ 30% decrease in MD of TL | ||
| SD | < 30% decrease to ≤20% increase in MD of TL | ||
| PD | > 20% increase from maximum response of TL | ||
| Necrosis | mRECIST | CR | Disappearance of any intratumoral enhancement in all TL |
| PR | ≥ 30% decrease in SMD of enhancing tissue in TL | ||
| SD | < 30% decrease to ≤20% in SMD of enhancing tissue in TL | ||
| PD | > 20% increase in amount of enhancing tissue in TL | ||
| EASLmeas | CR | Disappearance of any intratumoral enhancement in all TL | |
| and | PR | ≥ 50% decrease in amount of enhancing tissue in TL | |
| EASLest | SD | < 50% decrease in amount of enhancing tissue in TL | |
| PD | > 25% increase in amount of enhancing tissue in TL and/or new enhancement in previously treated lesions | ||
| LI-RADS | Nonviable | No suspicious lesion enhancement | |
| Equivocal | Atypical enhancement not meeting criteria to viable tumor | ||
| Viable | Nodular, mass-like, or thick irregular tissue in or along the treated lesion with any of the following: arterial phase hyperenhancement or washout appearance or enhanced similar to pretreatment 100% of tumor necrosis or reduction | ||
| RECICL | TE4 a | Necrotized area larger than the tumor (enough ablative margin) | |
| b | Necrotized area similar in size to the tumor (insufficient ablative margin) | ||
| TE3 | 50–100% of tumor necrosis or reduction | ||
| TE2 | Other effect than TE3 and TE1 | ||
| TE1 | Tumor enlargement of > 25% regardless of necrosis |
CR = complete response, CP = cross-product, EASL = European Association for the Study of Liver, LI-RADS = Liver Imaging Reporting and Data System, MD = maximum diameter, PD = progressive disease, PR = partial response, RECIST = Response Evaluation Criteria for Solid Tumors, mRECIST = modified RECIST, RECICL = Response Evaluation Criteria in Cancer of the Liver, SD = stable disease, SMD = sum of maximum diameters, TE = treatment effect, TL = target lesion(s), WHO = World Health Organization