Table 7. Assessment of Tumor Response*.
| RECIST | mRECIST | |
|---|---|---|
| Target lesions response | ||
| CR | Disappearance of all target lesions | Disappearance of any intratumoral arterial enhancement in all target lesions |
| PR | At least 30% decrease in sum of diameters of target lesions, taking as reference baseline sum of diameters of target lesions | At least 30% decrease in sum of diameters of viable (enhancement in arterial phase) target lesions, taking as reference baseline sum of diameters of target lesions |
| SD | Any cases that do not qualify for either PR or PD | Any cases that do not qualify for either PR or PD |
| PD | Increase of at least 20% in sum of diameters of target lesions, taking as reference smallest sum of diameters of target lesions recorded since treatment started | Increase of at least 20% in sum of diameters of viable (enhancing) target lesions, taking as reference smallest sum of diameters of viable (enhancing) target lesions recorded since treatment started |
| Non-target lesions response | ||
| CR | Disappearance of all nontarget lesions | Disappearance of any intratumoral arterial enhancement in all nontarget lesions |
| IR/SD | Persistence of one or more nontarget lesions | Persistence of intratumoral arterial enhancement in one or more nontarget lesions |
| PD | Appearance of one or more new lesions and/or unequivocal progression of existing nontarget lesions | Appearance of one or more new lesions and/or unequivocal progression of existing nontarget lesions |
| mRECIST recommendations | ||
| Pleural effusion and ascites | Cytopathologic confirmation of neoplastic nature of any effusion that appears or worsens during treatment is required to declare PD | |
| Porta hepatis lymph node | Lymph nodes detected at porta hepatis can be considered malignant if lymph node short axis is at least 2 cm | |
| Portal vein invasion | Malignant portal vein invasion should be considered as non-measurable lesion and thus included in nontarget lesion group | |
| New Lesion | New lesion can be classified as HCC if its longest diameter is at least 1 cm and enhancement pattern is typical for HCC. Lesion with atypical radiological pattern can be diagnosed as HCC by evidence of at least 1 cm interval growth | |
*Adapted from European Association for the Study of the Liver, et al. J Hepatol 2012;56:908-943 (77) and Lencioni et al. Semin Liver Dis 2010;30:52-60 (728), with permission of Georg Thieme Verlag KG. CR = complete response, IR = incomplete response, mRECIST = modified RECIST, PD = progressive disease, PR = partial response, RECIST = Response Evaluation Criteria in Solid Tumors, SD = stable disease