The DOI matches its Crossref record; 132 of the 157 references it cites were found in a registry or an index.
From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors
Open accessAbstract
UNLABELLED: The purpose of this article is to review the status and limitations of anatomic tumor response metrics including the World Health Organization (WHO) criteria, the Response Evaluation Criteria in Solid Tumors (RECIST), and RECIST 1.1. This article also reviews qualitative and quantitative approaches to metabolic tumor response assessment with (18)F-FDG PET and proposes a draft framework for PET Response Criteria in Solid Tumors (PERCIST), version 1.0. METHODS: PubMed searches, including searches for the terms RECIST, positron, WHO, FDG, cancer (including specific types), treatment response, region of interest, and derivative references, were performed. Abstracts and articles judged most relevant to the goals of this report were reviewed with emphasis on limitations and strengths of the anatomic and PET approaches to treatment response assessment. On the basis of these data and the authors' experience, draft criteria were formulated for PET tumor response to treatment. RESULTS: Approximately 3,000 potentially relevant references were screened. Anatomic imaging alone using standard WHO, RECIST, and RECIST 1.1 criteria is widely applied but still has limitations in response assessments. For example, despite effective treatment, changes in tumor size can be minimal in tumors such as lymphomas, sarcoma, hepatomas, mesothelioma, and gastrointestinal stromal tumor. CT tumor density, contrast enhancement, or MRI characteristics appear more informative than size but are not yet routinely applied. RECIST criteria may show progression of tumor more slowly than WHO criteria. RECIST 1.1 criteria (assessing a maximum of 5 tumor foci, vs. 10 in RECIST) result in a higher complete response rate than the original RECIST criteria, at least in lymph nodes. Variability appears greater in assessing progression than in assessing response. Qualitative and quantitative approaches to (18)F-FDG PET response assessment have been applied and require a consistent PET methodology to allow quantitative assessments. Statistically significant changes in tumor standardized uptake value (SUV) occur in careful test-retest studies of high-SUV tumors, with a change of 20% in SUV of a region 1 cm or larger in diameter; however, medically relevant beneficial changes are often associated with a 30% or greater decline. The more extensive the therapy, the greater the decline in SUV with most effective treatments. Important components of the proposed PERCIST criteria include assessing normal reference tissue values in a 3-cm-diameter region of interest in the liver, using a consistent PET protocol, using a fixed small region of interest about 1 cm(3) in volume (1.2-cm diameter) in the most active region of metabolically active tumors to minimize statistical variability, assessing tumor size, treating SUV lean measurements in the 1 (up to 5 optional) most metabolically active tumor focus as a continuous variable, requiring a 30% decline in SUV for "response," and deferring to RECIST 1.1 in cases that do not have (18)F-FDG avidity or are technically unsuitable. Criteria to define progression of tumor-absent new lesions are uncertain but are proposed. CONCLUSION: Anatomic imaging alone using standard WHO, RECIST, and RECIST 1.1 criteria have limitations, particularly in assessing the activity of newer cancer therapies that stabilize disease, whereas (18)F-FDG PET appears particularly valuable in such cases. The proposed PERCIST 1.0 criteria should serve as a starting point for use in clinical trials and in structured quantitative clinical reporting. Undoubtedly, subsequent revisions and enhancements will be required as validation studies are undertaken in varying diseases and treatments.
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“SUVmax of normal background tissues, including the liver and mediastinal blood pool are commonly used as references to define the disease and assess tumor response to therapy.[7]”
From Intrapatient variability of 18F-FDG uptake in normal tissues (2022) · cites this paper as [7]
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“However, it has been demonstrated that inter-rater agreement in response assessment with [18F]FDG-PET in non-small cell lung cancer or metastatic breast cancer can be considerably improved through the use of the target lesion SULpeak (PERCIST 1.0 criteria) in comparison with a subjective assessment [194,214,215].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [194]
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Cites
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BackgroundProgress and Promise of FDG-PET Imaging for Cancer Patient Management and Oncologic Drug Development
Kelloff, G. J., Hoffman, J. M., Johnson, B. E., Scher, H. I., Siegel, B. A., Cheng, E. Y., Cheson, B. D., O’Shaughnessy, J., Guyton, K. Z., Mankoff, D. A., et al. (2005) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-04-2626 · Cited by 683
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“Choosing a threshold based on a single maximal pixel value in the tumor carries with it the variability inherent in determining a single-pixel value and is driven by that value (104,109,112,119,120).”
BackgroundTherapeutic implications of cancer stem cells
Al‐Hajj, M., Becker, M. W., Wicha, M. S., Weissman, I. L., & Clarke, M. F. (2003) · Current Opinion in Genetics & Development · doi:10.1016/j.gde.2003.11.007 · Cited by 570
We should desist using RECIST, at least in GIST.
Benjamin, R., Choi, H., Macapinlac, H., Burgess, M., Patel, S. R., Chen, L. L., Podoloff, D., & Charnsangavej, C. (2007) · Journal of Clinical Oncology · doi:10.1200/jco.2006.07.3411 · Cited by 570 · cited 7×
“Additional anatomic characteristics of GIST, such as the development of mural nodules, but not necessarily with tumor growth because of the predominantly cystic nature of the tumors, are indicative of progression and of a poor outcome (48,49).”
BackgroundInfluentialClonogenic Multiple Myeloma Progenitors, Stem Cell Properties, and Drug Resistance
Matsui, W. H., Wang, Q., Barber, J. P., Brennan, S. K., Smith, B. D., Borrello, I., McNiece, I., Lin, L., Ambinder, R. F., Peacock, C. D., et al. (2008) · Cancer Research · doi:10.1158/0008-5472.can-07-3096 · Cited by 539
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“When lower thresholds of, for example, 20%230% are accepted as responses, limited data suggest that these patients are unlikely to have a medically relevant response, even if the response is statistically significant (87,130).”
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“Additional anatomic characteristics of GIST, such as the development of mural nodules, but not necessarily with tumor growth because of the predominantly cystic nature of the tumors, are indicative of progression and of a poor outcome (48,49).”
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“Although a range of factors has been associated with 18F-FDG uptake, there appears to be a rather strong relationship between 18F-FDG uptake and cancer cell number in a substantial number of studies (62,63).”
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“demonstrated that a negative 18F-FDG PET scan could help distinguish brain tumor necrosis from viable tumor at the end of therapy, despite the overlapping anatomic appearance of brain tumor and necrosis on CT (16,17).”
BackgroundRECIST revisited: a review of validation studies on tumour assessment.
Therasse, P., Eisenhauer, E., & Verweij, J. (2006) · European Journal of Cancer · doi:10.1016/j.ejca.2006.01.026 · Cited by 450 · cited 1×
“recently reviewed the use of RECIST in about 60 papers and American Society of Clinical Oncology meeting abstracts (37,38).”
Manus, M. M., Hicks, R., Matthews, J., McKenzie, A., Rischin, D., Salminen, E., & Ball, D. (2003) · Journal of Clinical Oncology · doi:10.1200/jco.2003.07.054 · Cited by 450 · cited 1×
“In the Hicks qualitative PET criteria (Table 5), multiple lesions are assessed (76,84,92,141).”
BackgroundEvaluation of tumor response after locoregional therapies in hepatocellular carcinoma
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“It has been demonstrated that adding PET to the posttherapy CT is especially useful in identifying which of these patients have achieved a satisfactory functional remission (60,61).”
BackgroundWahl, R. L., Siegel, B., Coleman, R., & Gatsonis, C. G. (2004) · Journal of Clinical Oncology · doi:10.1200/jco.2004.04.148 · Cited by 368 · cited 1×
“76 (area under the curve) (95) in over 300 patients evaluated independently by each reader.”
BackgroundSelf-citationDowney, R., Akhurst, T., Ilson, D., Ginsberg, R., Bains, M., Gonen, M., Koong, H., Gollub, M., Minsky, B., Zakowski, M., et al. (2003) · Journal of Clinical Oncology · doi:10.1200/jco.2003.04.013 · Cited by 347
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“35 times the mean liver SUV 1 2 SDs were assessed, the mean decline in SUV was about 50% in responders and 18% in nonresponders (126).”
BackgroundPrognostic value of interim FDG-PET after two or three cycles of chemotherapy in Hodgkin lymphoma.
Hutchings, M., Mikhaeel, N., Fields, P., Nunan, T., & Timothy, A. (2005) · Annals of Oncology · doi:10.1093/annonc/mdi200 · Cited by 344 · cited 1×
“This is possibly similar to the ‘‘minimal residual uptake’’ category reported in treated lymphomas by Mikhaeel’s group (89,98).”
ResultFlamen, P., Van Cutsem, E., Lerut, A., Cambier, J.-P., Haustermans, K., Bormans, G., De Leyn, P., Van Raemdonck, D., De Wever, W., Ectors, N., et al. (2002) · Annals of Oncology · doi:10.1093/annonc/mdf081 · Cited by 341
Positron Emission Tomography As an Imaging Biomarker
Weber, W. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2006.06.6068 · Cited by 313
Utility of PET, CT, and EUS to Identify Pathologic Responders in Esophageal Cancer
Swisher, S. G., Maish, M. S., Erasmus, J. J., Correa, A. M., Ajani, J. A., Bresalier, R. S., Komaki, R. U., Macapinlac, H. A., Munden, R. F., Putnam, J. B., et al. (2004) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2004.04.046 · Cited by 297
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The Lessons of GIST—PET and PET/CT: A New Paradigm for Imaging
den Abbeele, A. D. V. (2008) · The Oncologist · doi:10.1634/theoncologist.13-s2-8 · Cited by 287
Krak, N., Boellaard, R., Hoekstra, O., Twisk, J., Hoekstra, C., & Lammertsma, A. (2005) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-004-1566-1 · Cited by 284 · cited 7×
“Absolute and rigorous standardization of the protocol for PET is required to achieve reproducible SUVs.”
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“However, several papers have shown that in lung cancer, for example, a decline in a tumor SUV to below 4–6 after treatment separates groups of patients with longer and shorter survival reasonably well (72,127).”
BackgroundHoekstra, C., Stroobants, S., Smit, E., Vansteenkiste, J., van Tinteren, H., Postmus, P., Golding, R., Biesma, B., Schramel, F. J. H. M., van Zandwijk, N., et al. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.01.1189 · Cited by 283 · cited 1×
“have shown that metastatic-tumor-involved mediastinal nodal pathology and clinical behavior are well predicted by changes in SUV and absolute SUV in the primary lung cancer and by qualitative visual assessments of nodal status (66,142).”
BackgroundEvaluation of lymph nodes with RECIST 1.1.
Schwartz, L., Bogaerts, J., Ford, R., Shankar, L., Therasse, P., Gwyther, S., & Eisenhauer, E. (2009) · European Journal of Cancer · doi:10.1016/j.ejca.2008.10.028 · Cited by 283
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“When lower thresholds of, for example, 20%230% are accepted as responses, limited data suggest that these patients are unlikely to have a medically relevant response, even if the response is statistically significant (87,130).”
BackgroundMinn, H., Zasadny, K., Quint, L. E., & Wahl, R. (1995) · Radiology · doi:10.1148/radiology.196.1.7784562 · Cited by 280 · cited 10×
“(113) used a smaller maximal pixel volume, but it was still about 19 times larger than the volume of a single voxel used in many current scanners.”
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“usually somewhat less than) SUVs normalized on the basis of total body mass (30,102,103).”
BackgroundSelf-citationBoellaard, R., Oyen, W., Hoekstra, C., Hoekstra, O., Visser, E., Willemsen, A., Arends, B., Verzijlbergen, F., Zijlstra, J., Paans, A., et al. (2008) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-008-0874-2 · Cited by 265
Swisher, S. G., Erasmus, J., Maish, M. S., Correa, A. M., Macapinlac, H. A., Ajani, J. A., Cox, J. D., Komaki, R. R., Hong, D. S., Lee, H. K., et al. (2004) · Cancer · doi:10.1002/cncr.20585 · Cited by 263
From PET detectors to PET scanners
Humm, J., Rosenfeld, A., & Guerra, A. D. (2003) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-003-1266-2 · Cited by 249 · cited 1×
“0-cm diameter (67,68), which translates into a tumor size roughly of 0.”
BackgroundFluorodeoxyglucose uptake in the aortic wall at PET/CT: possible finding for active atherosclerosis.
Tatsumi, M., Cohade, C., Nakamoto, Y., & Wahl, R. (2003) · Radiology · doi:10.1148/radiol.2293021168 · Cited by 228 · cited 1×
“it is less effort to draw a 3-cm-diameter ROI on the right lobe of the liver than to repeatedly draw regions of interest on the aorta on multiple levels, taking care to avoid including uptake in the possibly diseased vessel wall (113,114,124,140).”
BackgroundSelf-citationRatain, M. J., & Eckhardt, S. G. (2004) · Journal of Clinical Oncology · doi:10.1200/jco.2004.07.960 · Cited by 227 · cited 5×
“PET/CT images obtained before (1) and after (2) treatment of pancreatic carcinoma with experimental therapy targeting mammalian target of rapamycin.”
BackgroundInfluentialBoellaard, R., Oyen, W., Hoekstra, C., Hoekstra, O., Visser, E., Willemsen, A., Arends, B., Verzijlbergen, F., Zijlstra, J., Paans, A., et al. (2008) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-008-0954-3 · Cited by 222 · cited 4×
“Key elements of PERCIST include performance of PET scans in a method consistent with the National Cancer Institute recommendations and those of The Netherlands multicenter trial group (30) on well-calibrated and well-maintained scanners.”
BackgroundInfluentialPöttgen, C., Levegrün, S., Theegarten, D., Marnitz, S., Grehl, S., Pink, R., Eberhardt, W., Stamatis, G., Gauler, T., Antoch, G., et al. (2006) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-05-0510 · Cited by 222 · cited 1×
“Studies in which complex partial-volume corrections have been performed in addition to corrections for background spillover from nearby tissues have sometimes, but not consistently, demonstrated quantitation to be superior to visual assessments for predicting response and outcome (136).”
BackgroundFrancis, R., Byrne, M., van der Schaaf, A. A., Bouček, J., Nowak, A., Phillips, M., Price, R., Patrikeos, A., Musk, A., & Millward, M. (2007) · Journal of Nuclear Medicine · doi:10.2967/jnumed.107.042333 · Cited by 218 · cited 3×
“A background threshold approach has been developed as a tool for defining metabolic tumor volumes for mesotheliomas with good initial success, choosing 3 SDs above background levels for segmentation (111).”
BackgroundMethodGuillem, J., Moore, H., Akhurst, T., Klimstra, D., Ruo, L., Mazumdar, M., Minsky, B., Saltz, L., Wong, W., & Larson, S. (2004) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2004.02.024 · Cited by 205 · cited 2×
“Choosing a threshold based on a single maximal pixel value in the tumor carries with it the variability inherent in determining a single-pixel value and is driven by that value (104,109,112,119,120).”
BackgroundSpaepen, K., Stroobants, S., Dupont, P., Bormans, G., Balzarini, J., Verhoef, G., Mortelmans, L., Vandenberghe, P., & Wolf-Peeters, C. (2003) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-003-1120-6 · Cited by 203
Individual patient data analysis to assess modifications to the RECIST criteria.
Bogaerts, J., Ford, R., Sargent, D., Schwartz, L., Rubinstein, L., Lacombe, D., Eisenhauer, E., Verweij, J., & Therasse, P. (2009) · European Journal of Cancer · doi:10.1016/j.ejca.2008.10.027 · Cited by 201 · cited 1×
“If tumors other than these 5 progress unequivocally, progression has occurred (39,40).”
BackgroundNahmias, C., & Wahl, L. M. (2008) · Journal of Nuclear Medicine · doi:10.2967/jnumed.108.054239 · Cited by 199 · cited 9×
“Concordantly, Nahmias and Wahl (115) showed in test–retest studies that absolute differences in mean SUV obtained from a large ROI did not exceed 0.5 SUV unit and that the absolute differences in mean SUV decreased as mean SUV increased.”
BackgroundMethodInfluentialMeasuring response in a post-RECIST world: from black and white to shades of grey
Michaelis, L., & Ratain, M. (2006) · Nature Reviews. Cancer · doi:10.1038/nrc1883 · Cited by 197 · cited 3×
“With such reductionism, potential valuable information that may be important is lost (1,2,4,10).”
BackgroundRandomized discontinuation design: application to cytostatic antineoplastic agents.
Rosner, G., Stadler, W., & Ratain, M. (2002) · Journal of Clinical Oncology · doi:10.1200/jco.2002.11.126 · Cited by 195 · cited 1×
“With such newer treatments, lack of progression may be associated with a good improvement in outcome, even in the absence of major shrinkage of tumors as evidenced by partial response or complete response (2,3).”
BackgroundCerfolio, R. J., Bryant, A. S., Winokur, T. S., Ohja, B., & Bartolucci, A. A. (2004) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2004.06.102 · Cited by 194
Levine, E., Farmer, M., Clark, P. B., Mishra, G., Ho, C., Geisinger, K., Melin, S., Lovato, J., Oaks, T., & Blackstock, A. (2006) · Annals of Surgery · doi:10.1097/01.sla.0000208430.07050.61 · Cited by 181
Karrison, T. G., Maitland, M. L., Stadler, W. M., & Ratain, M. J. (2007) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djm158 · Cited by 179 · cited 4×
“PET/CT images obtained before (1) and after (2) treatment of pancreatic carcinoma with experimental therapy targeting mammalian target of rapamycin.”
BackgroundInfluentialHicks, R., Manus, M. M., Matthews, J., Hogg, A., Binns, D., Rischin, D., Ball, D., & Peters, L. (2004) · International Journal of Radiation Oncology, Biology, Physics · doi:10.1016/j.ijrobp.2004.03.036 · Cited by 175
Comparison of simplified quantitative analyses of FDG uptake
Graham, M. M., Peterson, L. M., & Hayward, R. M. (2000) · Nuclear Medicine and Biology · doi:10.1016/s0969-8051(00)00143-8 · Cited by 174 · cited 1×
“More than 30 different ways to monitor tumor response have been discussed, but the SUV appears to be the most widely applied, generally correlating well with more complex analytic approaches (100,101).”
BackgroundAkhurst, T., Downey, R., Ginsberg, M., Gonen, M., Bains, M., Korst, R., Ginsberg, R., Rusch, V., & Larson, S. (2002) · Annals of Thoracic Surgery · doi:10.1016/s0003-4975(01)03257-x · Cited by 174
Armitage, J., Weisenburger, D., Hutchins, M., Moravec, D., Dowling, M., Sorensen, S., Mailliard, J., Okerbloom, J., Johnson, P. S., & Howe, D. (1986) · Journal of Clinical Oncology · doi:10.1200/jco.1986.4.2.160 · Cited by 172 · cited 1×
“For example, in lymphomas, patients whose tumors shrink the most rapidly are most likely to do well, and they may need less treatment (55).”
BackgroundKaplan, W. D., Jochelson, M., Herman, T., Nadler, L., Stomper, P., Takvorian, T., Andersen, J. W., & Canellos, G. (1990) · Journal of Clinical Oncology · doi:10.1200/jco.1990.8.12.1966 · Cited by 170 · cited 1×
“showed that a positive 67Ga scan midway through or at the end of treatment of patients with diffuse large cell lymphoma predicted a poor outcome in comparison to patients whose scans had normalized, even if residual masses were over 10 cm in size (11).”
ResultManus, M. M., Hicks, R., Matthews, J., Wirth, A., Rischin, D., & Ball, D. (2005) · Lung Cancer · doi:10.1016/j.lungcan.2004.11.024 · Cited by 164 · cited 1×
“In the Hicks qualitative PET criteria (Table 5), multiple lesions are assessed (76,84,92,141).”
BackgroundVansteenkiste, J., Stroobants, S. G., Leyn, P. R. D., Dupont, P. J., & Verbeken, E. K. (1998) · Annals of Oncology · doi:10.1023/a:1008437915860 · Cited by 155
Bryant, A., Cerfolio, R., Klemm, K., & Ojha, B. C. (2006) · Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2005.12.047 · Cited by 154
The paradox of response and survival in cancer therapeutics
Huff, C. A., Matsui, W. H., Smith, B. D., & Jones, R. J. (2005) · Blood · doi:10.1182/blood-2005-06-2517 · Cited by 151
Ott, K., Herrmann, K., Lordick, F., Wieder, H., Weber, W., Becker, K., Buck, A., Dobritz, M., Fink, U., Ulm, K., et al. (2008) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-07-0934 · Cited by 151 · cited 1×
“Similarly, in sarcoma and gastric and ovarian carcinoma responses, a drop in SUV of more than 25% is associated with the best outcomes (43,87,137,138).”
BackgroundMinn, H. R. I., & Soini, I. (1989) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/bf00702620 · Cited by 143 · cited 1×
“Planar imaging and SPECT with 18F-FDG showed that breast cancers and lymphomas had qualitative declines in tracer uptake with effective treatment (18,19).”
MethodUse of PET to monitor the response of lung cancer to radiation treatment
Erdi, Y., Macapinlac, H., Rosenzweig, K., Humm, J., Larson, S., Erdi, A. K., & Yorke, E. (2000) · European Journal of Nuclear Medicine · doi:10.1007/s002590000258 · Cited by 141 · cited 2×
“Choosing a threshold based on a single maximal pixel value in the tumor carries with it the variability inherent in determining a single-pixel value and is driven by that value (104,109,112,119,120).”
BackgroundThe significance of the residual mediastinal mass in treated Hodgkin's disease.
Jochelson, M., Mauch, P., Balikian, J., Rosenthal, D. N., & Canellos, G. (1985) · Journal of Clinical Oncology · doi:10.1200/jco.1985.3.5.637 · Cited by 141 · cited 1×
“Briefly, residual or even bulky masses after therapy completion are frequent in both Hodgkin disease and non-Hodgkin lymphoma but correlate poorly with survival (58).”
BackgroundOptimising the design of phase II oncology trials: the importance of randomisation.
Ratain, M., & Sargent, D. (2009) · European Journal of Cancer · doi:10.1016/j.ejca.2008.10.029 · Cited by 139 · cited 2×
“With such reductionism, potential valuable information that may be important is lost (1,2,4,10).”
BackgroundDirect Comparison of FDG PET and CT Findings in Patients with Lymphoma: Initial Experience
Tatsumi, M., Cohade, C., Nakamoto, Y., Fishman, E. K., & Wahl, R. L. (2005) · Radiology · doi:10.1148/radiol.2373040555 · Cited by 138 · cited 1×
“0-cm diameter (67,68), which translates into a tumor size roughly of 0.”
BackgroundSelf-citationKim, M. K., Ryu, J., Kim, S.-B., Ahn, J., Kim, S., Park, S.-I., Kim, Y. H., Song, H., Shin, J., Jung, H.-Y., et al. (2007) · European Journal of Cancer · doi:10.1016/j.ejca.2007.04.001 · Cited by 127 · cited 1×
“Because a growing body of data suggests that patients whose scans rapidly normalize are those most likely to have a favorable outcome, a disease-assessment scan performed soon after the beginning of treatment provides much information predictive of subsequent outcomes (85).”
BackgroundMonitoring chemotherapy and radiotherapy of solid tumors
Weber, W., & Wieder, H. (2006) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-006-0133-3 · Cited by 126 · cited 1×
“Since that report, there have been many others in a wide range of tumors (21,22).”
Backgroundvan Klaveren, R. V., Aerts, J., de Bruin, H. D., Giaccone, G., Manegold, C., & van Meerbeeck, J. V. (2004) · Lung Cancer · doi:10.1016/s0169-5002(03)00292-7 · Cited by 126
Hellwig, D., Graeter, T., Ukena, D., Georg, T., Kirsch, C., & Schäfers, H. (2004) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2004.07.031 · Cited by 121 · cited 2×
“However, several papers have shown that in lung cancer, for example, a decline in a tumor SUV to below 4–6 after treatment separates groups of patients with longer and shorter survival reasonably well (72,127).”
BackgroundSugawara, Y., Zasadny, K. R., Grossman, H. B., Francis, I. R., Clarke, M. F., & Wahl, R. L. (1999) · Radiology · doi:10.1148/radiology.211.1.r99ap16249 · Cited by 119 · cited 1×
“Ki is an attractive parameter and may be helpful when the SUV after treatment is low (117).”
BackgroundSelf-citationDooms, C., Verbeken, E., Stroobants, S., Nackaerts, K., Leyn, P. D., & Vansteenkiste, J. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2007.13.9550 · Cited by 118 · cited 1×
“have shown that metastatic-tumor-involved mediastinal nodal pathology and clinical behavior are well predicted by changes in SUV and absolute SUV in the primary lung cancer and by qualitative visual assessments of nodal status (66,142).”
BackgroundLessons learned from independent central review.
Ford, R., Schwartz, L., Dancey, J., Dodd, L. E., Eisenhauer, E., Gwyther, S., Rubinstein, L., Sargent, D., Shankar, L., Therasse, P., et al. (2009) · European Journal of Cancer · doi:10.1016/j.ejca.2008.10.031 · Cited by 117
Benz, M., Allen-Auerbach, M., Eilber, F., Chen, H. J. J., Dry, S., Phelps, M., Czernin, J., & Weber, W. (2008) · Journal of Nuclear Medicine · doi:10.2967/jnumed.108.053694 · Cited by 116 · cited 8×
“Measuring tumor or node size with CT from PET/CT is feasible, but slight errors in those mea- RECIST TO PERCIST: PET TUMOR RESPONSE • Wahl et al. 139S T A B L E 7 .”
BackgroundInfluentialNakamoto, Y., Zasadny, K., Minn, H., & Wahl, R. (2002) · Molecular Imaging and Biology · doi:10.1016/s1536-1632(01)00004-x · Cited by 115 · cited 6×
“Absolute and rigorous standardization of the protocol for PET is required to achieve reproducible SUVs.”
BackgroundInfluentialSelf-citationPort, J., Kent, M., Korst, R., Keresztes, R., Levin, M., & Altorki, N. (2004) · Annals of Thoracic Surgery · doi:10.1016/s0003-4975(03)01457-7 · Cited by 112
Assessment of tumor response on MR imaging after locoregional therapy.
Vossen, J., Buijs, M., & Kamel, I. (2006) · Techniques in Vascular and Interventional Radiology · doi:10.1053/j.tvir.2007.02.004 · Cited by 104 · cited 1×
“In hepatomas, alternative criteria to RECIST have been developed, referred to as the EASL (European Association for the Study of the Liver) criteria (44,50).”
MethodCachin, F., Prince, H., Hogg, A., Ware, R., & Hicks, R. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2005.04.6326 · Cited by 99
Measuring [18F]FDG uptake in breast cancer during chemotherapy: comparison of analytical methods
Krak, N. C., van der Hoeven, J. J. M., Hoekstra, O. S., Twisk, J. W. R., van der Wall, E., & Lammertsma, A. A. (2003) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-003-1127-z · Cited by 94 · cited 3×
“More than 30 different ways to monitor tumor response have been discussed, but the SUV appears to be the most widely applied, generally correlating well with more complex analytic approaches (100,101).”
BackgroundMethodOverview of early response assessment in lymphoma with FDG-PET
MacManus, M., Seymour, J., & Hicks, R. (2007) · Cancer Imaging · doi:10.1102/1470-7330.2007.0004 · Cited by 86
Aggressive non-Hodgkin lymphoma: early prediction of outcome with 67Ga scintigraphy.
Front, D., Bar-Shalom, R., Mor, M., Haim, N., Epelbaum, R., Frenkel, A., Gaitini, D., Kolodny, G., & Israel, O. (2000) · Radiology · doi:10.1148/radiology.214.1.r00ja03253 · Cited by 84 · cited 1×
“67Ga results, qualitatively reported as positive or negative, were significantly predictive of outcome, with a negative 67Ga scan predicting a favorable outcome (12,14,15).”
BackgroundSelection of response criteria for clinical trials of sarcoma treatment.
Schuetze, S., Baker, L., Benjamin, R., & Canetta, R. (2008) · The Oncologist · doi:10.1634/theoncologist.13-s2-32 · Cited by 83 · cited 2×
“There is great interest in surrogate metrics for survival after investigational cancer treatments, such as response rate, time to tumor progression, or progression-free survival (5).”
BackgroundMelton, G. B., Lavely, W. C., Jacene, H. A., Schulick, R. D., Choti, M. A., Wahl, R. L., & Gearhart, S. L. (2007) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-007-0170-7 · Cited by 82 · cited 5×
“Tumor histologic status was well associated with changes in tumor volumes in neoadjuvant therapy of colorectal cancer, however (57).”
BackgroundMethodInfluentialSelf-citationCollege athletics, body size, and cancer mortality
Polednak, A. P. (1976) · Cancer · doi:10.1002/1097-0142(197607)38:1 · Cited by 81
Maskens, A. P., & Dujardin‐Loits, R. (1981) · Cancer · doi:10.1002/1097-0142(19810101)47:1 · Cited by 75
Ceresoli, G., Chiti, A., Zucali, P., Vincenzo, F. D., Rodari, M., Lutman, R., Salamina, S., Garassino, I., Campagnoli, E., Cavina, R., et al. (2006) · Journal of Clinical Oncology · doi:10.1016/s0169-5002(07)70156-3 · Cited by 75 · cited 1×
“However, SUVmax is also a potent predictor of outcomes in other studies of mesothelioma (52,129) and is quite strong in the data of Francis et al.”
ResultDuong, C., Demitriou, H., Weih, L., Thompson, A., Williams, D., Thomas, R. J. S., & Hicks, R. (2006) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-005-0028-8 · Cited by 74
Hodgkin disease: prediction of outcome with 67Ga scintigraphy after one cycle of chemotherapy.
Front, D., Bar-Shalom, R., Mor, M., Haim, N., Epelbaum, R., Frenkel, A., Gaitini, D., Kolodny, G., & Israel, O. (1999) · Radiology · doi:10.1148/radiology.210.2.r99fe07487 · Cited by 74
Plathow, C., Klopp, M., Thieke, C., Herth, F., Thomas, A., Schmaehl, A., Zuna, I., & Kauczor, H. (2008) · European Radiology · doi:10.1007/s00330-008-0918-9 · Cited by 70
Kasamon, Y. L., Wahl, R., Ziessman, H., Blackford, A., Goodman, S., Fidyk, C., Rogers, K. M., Bolaños-Meade, J., Borowitz, M., Ambinder, R., et al. (2009) · Biology of Blood and Marrow Transplantation · doi:10.1016/j.bbmt.2008.11.026 · Cited by 64 · cited 2×
“We have used a 5-point visual assessment scale in our patients with non-Hodgkin lymphoma during therapy, and a 4-point scale in colorectal cancer after treatment, recognizing that response does likely represent a continuum of intensities of uptake (57,90).”
MethodSelf-citationFDG PET and risk-adapted therapy in Hodgkin's and non-Hodgkin's lymphoma
Kasamon, Y. L., & Wahl, R. (2008) · Current Opinion in Oncology · doi:10.1097/cco.0b013e3282f5123d · Cited by 63 · cited 2×
“Thus, a dose of therapy that produces a 90% (1 log) reduction in tumor mass will have to be repeated 11 times to eliminate a newly diagnosed cancer comprising 1011 cells (26,27).”
BackgroundSelf-citationDuong, C., Hicks, R., Weih, L., Drummond, E., Leong, T., Michael, M., & Thomas, R. J. S. (2006) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-005-0040-z · Cited by 63
Reinhardt, M., Herkel, C., Altehoefer, C., Finke, J., & Moser, E. (2005) · Annals of Oncology · doi:10.1093/annonc/mdi271 · Cited by 59 · cited 1×
“It has been demonstrated that adding PET to the posttherapy CT is especially useful in identifying which of these patients have achieved a satisfactory functional remission (60,61).”
BackgroundAssessment of tumor response in malignant pleural mesothelioma.
Ceresoli, G., Chiti, A., Zucali, P., Cappuzzo, F., Vincenzo, F. D., Cavina, R., Rodari, M., Poretti, D., Lutman, F. R., & Santoro, A. (2007) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2007.07.012 · Cited by 58 · cited 1×
“However, SUVmax is also a potent predictor of outcomes in other studies of mesothelioma (52,129) and is quite strong in the data of Francis et al.”
ResultFDG-PET Determination of Metabolically Active Tumor Volume and Comparison with CT.
Zasadny, K., Kison, P. V., Francis, I., & Wahl, R. (1998) · Clinical Positron Imaging · doi:10.1016/s1095-0397(98)00007-7 · Cited by 58 · cited 28×
“Francis has found total lesion glycolysis to be superior to SUVmax in mesothelioma response RECIST TO PERCIST: PET TUMOR RESPONSE • Wahl et al. 137S assessment.”
BackgroundInfluentialSelf-citationThe role of PET in monitoring therapy
Hicks, R. (2005) · Cancer Imaging · doi:10.1102/1470-7330.2005.0006 · Cited by 57
Roedl, J. B., Halpern, E. F., Colen, R. R., Sahani, D. V., Fischman, A. J., & Blake, M. A. (2008) · Molecular Imaging and Biology · doi:10.1007/s11307-008-0169-9 · Cited by 55 · cited 1×
“They could suffer from the variance intrinsic in the metabolic and anatomic methods, potentially reducing the precision of the methods, but initial results are encouraging in esophageal cancer treatment assessment (123).”
ResultHow to perform a comprehensive search for FDG-PET literature
Mijnhout, G. S., Hooft, L., van Tulder, M. V., Devillé, W., Teule, G. J. J., & Hoekstra, O. (2000) · European Journal of Nuclear Medicine · doi:10.1007/pl00006669 · Cited by 55
Neuroblastomas contain iron-rich ferritin
Iancu, T. C., Shiloh, H., & Kedar, A. (1988) · Cancer · doi:10.1002/1097-0142(19880615)61:12 · Cited by 53
18F-FDG PET/CT for Monitoring the Response of Lymphoma to Radioimmunotherapy
Jacene, H., Filice, R., Kasecamp, W., & Wahl, R. (2008) · Journal of Nuclear Medicine · doi:10.2967/jnumed.108.055376 · Cited by 53 · cited 1×
“However, in many studies the degree of SUV reduction associated with a complete metabolic response is less than 100% (139).”
BackgroundSelf-citationOxnard, G., & Schwartz, L. H. (2010) · Cancer · doi:10.1002/cncr.24803 · Cited by 44
FDG PET in lymphoma: The need for standardization of interpretation. An observer variation study
Zijlstra, J., Comans, E., van Lingen, A., Hoekstra, O., Gundy, C., Coebergh, J. W., & Bongers, V. (2007) · Nuclear medicine communications · doi:10.1097/mnm.0b013e3282eff2d5 · Cited by 44 · cited 1×
“Indeed, only a 56% concurrence rate was seen between less experienced readers and experts (99) in assessments of nonHodgkin lymphoma disease activity.”
BackgroundAccuracy of the EasyTouch blood glucose self-monitoring system: a study of 516 cases
Dai, K.-S., Tai, D.-Y., Ho, P., Chen, C.-C., Peng, W.-C., Chen, S.-T., Hsu, C.-C., Liu, Y.-P., Hsieh, H.-C., Yang, C.-C., et al. (2004) · Clinica Chimica Acta · doi:10.1016/j.cccn.2004.06.010 · Cited by 41 · cited 1×
“SUV should be corrected for lean body mass (SUL) and should not be corrected for serum glucose levels (glucose corrections have been variably useful, and errors in glucometer measurements are well known and may add errors (135)).”
BackgroundBarnacle, A., & McHugh, K. (2006) · Pediatric Blood & Cancer · doi:10.1002/pbc.20344 · Cited by 40
Mabille, M., Vanel, D., Albiter, M., Cesne, A. L., Bonvalot, S., Péchoux, C. L., Terrier, P., Shapeero, L., & Dromain, C. (2009) · European Journal of Radiology · doi:10.1016/j.ejrad.2008.10.009 · Cited by 36 · cited 1×
“Additional anatomic characteristics of GIST, such as the development of mural nodules, but not necessarily with tumor growth because of the predominantly cystic nature of the tumors, are indicative of progression and of a poor outcome (48,49).”
BackgroundCancer clinical trial outcomes: any progress in tumour-size assessment?
Verweij, J., Therasse, P., & Eisenhauer, E. (2009) · European Journal of Cancer · doi:10.1016/j.ejca.2008.10.025 · Cited by 35 · cited 1×
“recently reviewed the use of RECIST in about 60 papers and American Society of Clinical Oncology meeting abstracts (37,38).”
Update of the FDG PET search strategy
Mijnhout, G. S., Riphagen, I., & Hoekstra, O. (2004) · Nuclear medicine communications · doi:10.1097/00006231-200412000-00006 · Cited by 33
Israel, O., Mor, M., Epelbaum, R., Frenkel, A., Haim, N., Dann, E., Gaitini, D., Bar-Shalom, R., Kolodny, G., & Front, D. (2002) · Cancer · doi:10.1002/cncr.10344 · Cited by 31 · cited 1×
“67Ga results, qualitatively reported as positive or negative, were significantly predictive of outcome, with a negative 67Ga scan predicting a favorable outcome (12,14,15).”
BackgroundTumor Burden Assessment with Positron Emission Tomography with
Akhurst, T., Ng, Larson, S. M., O'Donoghue, J., O'Neel, J., Erdi, Y., & Divgi, C. (2000) · Clinical Positron Imaging · doi:10.1016/s1095-0397(00)00041-8 · Cited by 30 · cited 2×
“Choosing a threshold based on a single maximal pixel value in the tumor carries with it the variability inherent in determining a single-pixel value and is driven by that value (104,109,112,119,120).”
BackgroundNg, A. P., Wirth, A., Seymour, J., Lee, M. E., Hogg, A., Januszewicz, H., Wolf, M., Prince, H., MacManus, M., & Hicks, R. (2007) · Leukemia and Lymphoma · doi:10.1080/10428190601099965 · Cited by 29
Hoekstra, O., van Lingen, A., Ossenkoppele, G., Golding, R., & Teule, G. (1993) · European Journal of Nuclear Medicine · doi:10.1007/bf00171020 · Cited by 27 · cited 1×
“Planar imaging and SPECT with 18F-FDG showed that breast cancers and lymphomas had qualitative declines in tracer uptake with effective treatment (18,19).”
Methodvan der Putten, L., Hoekstra, O., de Bree, R., Kuik, D., Comans, E., Langendijk, J., & Leemans, C. (2008) · Molecular Imaging and Biology · doi:10.1007/s11307-008-0154-3 · Cited by 25 · cited 1×
“, neither positive nor negative), indicating the difficulty of dichotomizing the inherently continuously variable PET uptake patterns (97).”
Background[Gastrointestinal stromal tumors: role of computed tomography before and after treatment].
Bensimhon, D., Soyer, P., Brouland, J., Boudiaf, M., Fargeaudou, Y., & Rymer, R. (2008) · Gastroentérologie Clinique et Biologique · doi:10.1016/j.gcb.2007.12.015 · Cited by 20 · cited 1×
“Additional anatomic characteristics of GIST, such as the development of mural nodules, but not necessarily with tumor growth because of the predominantly cystic nature of the tumors, are indicative of progression and of a poor outcome (48,49).”
BackgroundFDG PET and high-dose therapy for aggressive lymphomas: toward a risk-adapted strategy
Kasamon, Y. L., Wahl, R., & Swinnen, L. (2004) · Current Opinion in Oncology · doi:10.1097/00001622-200403000-00003 · Cited by 19 · cited 1×
“Use of these socalled response-adaptive or risk-adaptive treatment approaches is expected to grow (28).”
BackgroundSelf-citationSmulders, S., Gundy, C., van Lingen, A., Comans, E., Smeenk, F., & Hoekstra, O. (2007) · Molecular Imaging and Biology · doi:10.1007/s11307-007-0108-1 · Cited by 16
Discordant Response to Chemotherapy Detected by PET Scanning: Unveiling of a Second Primary Cancer
Blum, R., Prince, H., Hicks, R., Patrikeos, A., & Seymour, J. (2002) · American Journal of Clinical Oncology · doi:10.1097/00000421-200208000-00010 · Cited by 10 · cited 1×
“This is in part because ‘‘child’’ metastases biologically resemble their ‘‘parents’’ (143,144).”
Time and Again, Children Resemble Their Parents
Hicks, R. (2008) · Journal of Nuclear Medicine · doi:10.2967/jnumed.108.052142 · Cited by 3 · cited 1×
“This is in part because ‘‘child’’ metastases biologically resemble their ‘‘parents’’ (143,144).”
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FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0
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HER kinase inhibition in patients with HER2- and HER3-mutant cancers
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A Systematic Review of the Factors Affecting Accuracy of SUV Measurements
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Metadata
- Authors
- Wahl, R. L., Jacene, H., Kasamon, Y., & Lodge, M. A.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Wahl, Richard L.
- Venue
- Journal of Nuclear Medicine
- Publisher
- Society of Nuclear Medicine
- Published
- 2009-04-29
- Volume
- 50
- Issue
- Suppl 1
- Pages
- 122S-150S
- ISSN
- 0161-5505 (ISSN-L)
- 2159-662X
- PMC
- PMC2755245
- OpenAlex
- W2155263737
- Cited by
- 3,777
- References
- 157
- Citations by year
- 2026: 180 · 2025: 200 · 2024: 197 · 2023: 230 · 2022: 248 · 2021: 309 · 2020: 271 · 2019: 259 · 2018: 225 · 2017: 274 · 2016: 246 · 2015: 245 · 2014: 221 · 2013: 230 · 2012: 192
- FWCI
- 21.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Nuclear Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (CA006973, P30CA006973)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Keywords
- RECIST, PERCIST, 18F-FDG PET, tumor response assessment, standardized uptake value, WHO criteria, RECIST 1.1, region of interest, treatment response assessment, solid tumors, lymphoma, sarcoma, hepatocellular carcinoma, mesothelioma, gastrointestinal stromal tumor, test-retest variability
- MeSH terms
- Forecasting, Humans, Neoplasms, Prognosis, World Health Organization, Treatment Outcome, Outcome Assessment, Health Care, Practice Guidelines as Topic, Radiopharmaceuticals, Fluorodeoxyglucose F18, Internationality, Positron-Emission Tomography
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