title: Imaging assessment of tumor response: past, present and future.
abstract: 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.
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
authors.forename: Asim
authors.initials: A
authors.lastname: Afaq
authors.forename: Oguz
authors.initials: O
authors.lastname: Akin
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D009369:Neoplasms / Q000175:diagnosis*; D055420:Perfusion Imaging / Q000379:methods