Evaluation of Response in Malignant Tumors Treated with Targeted Agents

  • Giuseppe Lo Re
  • Federica Vernuccio
  • Maria Cristina Galfano
  • Federico Midiri
  • Massimo Midiri
Part of the Current Clinical Pathology book series (CCPATH)


Targeted therapy is becoming an increasingly important component in the treatment of cancer. How to accurately monitor targeted therapy is crucial in clinical practice to evaluate treatment success, to identify complications, and to lead decision-making for subsequent therapy.

In the last decades, there has been a proliferation and divergence of many imaging-based tumor-specific response criteria whose purpose is to achieve objective assessment of treatment response in oncologic clinical trials.

The traditional methods of measuring tumor size were developed in the 1980s by the World Health Organisation (WHO). Thereafter, a task force that comprised the European Organization for Research and Treatment in Oncology, the National Cancer Institute of the United States, and the National Cancer Institute of Canada published the Response Evaluation Criteria in Solid Tumors (RECIST) in 2000 and revised them in 2009.

The WHO criteria and RECIST are mainly focused on the evaluation of anatomic tumor responses but target therapies may cause changes in tumor attenuation and do not necessarily cause marked tumor size reduction; thus, clinically meaningful responses to target therapies may be underestimated using these criteria. More recent criteria that are used for targeted therapies include the Choi response criteria for gastrointestinal stromal tumor, modified RECIST and European Association for the Study of the Liver (EASL) criteria for hepatocellular carcinoma, immune-related response criteria for melanoma, and response assessment in neuro-oncology (RANO) criteria for high-grade malignant glioma. Moreover, positron emission tomography is used to assess functional information and tumor viability in Cheson criteria and Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST).

This chapter focuses on the applications of all these different criteria evaluating the role of computed tomography- and positron emission tomography-based imaging strategies on monitoring targeted therapy.


Molecular targeted therapy Molecular imaging Computed tomography Positron emission tomography Oncologic imaging Hepatocellular carcinoma Malignant melanoma Gastrointestinal stromal tumor Malignant glioma 


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Giuseppe Lo Re
    • 1
  • Federica Vernuccio
    • 1
  • Maria Cristina Galfano
    • 1
  • Federico Midiri
    • 1
  • Massimo Midiri
    • 1
  1. 1.Department of Radiology, DIBIMEFUniversity Hospital of PalermoPalermoItaly

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