title: Comparison of WHO, RECIST 1.1, EORTC, and PERCIST criteria in the evaluation of treatment response in malignant solid tumors.
abstract: OBJECTIVE
  To compare response assessment according to the WHO, RECIST 1.1, EORTC, and PERCIST criteria in patients diagnosed with malignant solid tumors and who had received cytotoxic chemotherapy to establish the strength of agreement between each criterion.
  
  
  METHODS
  Sixty patients with malignant solid tumors were included in this retrospective study. The baseline and the sequential follow-up fluorine-18-fluorodeoxyglucose PET/computed tomography (CT) of each patient were evaluated according to the WHO, RECIST 1.1, EORTC, and PERCIST criteria. PET/CT images were used for both metabolic and anatomic evaluation. The concurrent diagnostic CT and MRI images (performed within 1 week of PET/CT) were also utilized when needed. The results were compared using the κ-statistics.
  
  
  RESULTS
  The response and progression rates according to the WHO criteria were 37 and 38%, respectively. The same ratios were also found for RECIST 1.1 (κ=1). The response and progression rates according to the EORTC criteria were 47 and 40%, respectively. When PERCIST criteria were used, one patient with progressive disease was upgraded to stable disease (κ=0.976). As we found the same results with WHO and RECIST 1.1 criteria, we used WHO criteria to compare the anatomic and metabolic criteria. When we compared the WHO and EORTC criteria, there was an agreement in 80% of the patients (κ=0.711). With WHO and PERCIST criteria, there was an agreement in 81.6% of the patients (κ=0.736).
  
  
  CONCLUSIONS
  Significant agreement was detected when the WHO, RECIST 1.1, EORTC, and PERCIST criteria were compared both within as well as between each other.
authors.affiliation: aDepartment of Nuclear Medicine, Bulent Ecevit University School of Medicine, Zonguldak Departments of bNuclear Medicine cMedical Oncology, Marmara University School of Medicine, Istanbul dDepartment of Nuclear Medicine, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aras
authors.forename: Tanju Y
authors.initials: TY
authors.lastname: Erdil
authors.forename: Faysal
authors.initials: F
authors.lastname: Dane
authors.forename: Serkan
authors.initials: S
authors.lastname: Gungor
authors.forename: Tunc
authors.initials: T
authors.lastname: Ones
authors.forename: Fuat
authors.initials: F
authors.lastname: Dede
authors.forename: Sabahat
authors.initials: S
authors.lastname: Inanir
authors.forename: Halil T
authors.initials: HT
authors.lastname: Turoglu
mesh_terms: D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D066066:Response Evaluation Criteria in Solid Tumors; D012189:Retrospective Studies; D014944:World Health Organization