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    Chief Complaint


    Organ System


    Patent Pending

    Modified Response Evaluation Criteria in Solid Tumors (mRECIST)

    Measures treatment response, specifically to cytotoxic drugs, based on tumor shrinkage.


    Use in liver lesions meeting the following criteria:

    • Can be accurately measured in at least one dimension as 10 mm or more (measure longest diameter).
    • Suitable for repeat measurement.
    • Intratumoral arterial enhancement on contrast-enhanced CT or MRI.
    When to Use
    Why Use

    Patients with hepatocellular carcinoma (HCC) who have undergone treatment (systemic, locoregional, and/or surgical).

    • Can identify patients who are not responding to therapy, in order to help guide decisions about modification of therapy, more quickly than traditional endpoints like morbidity and mortality.
    • Tumor response, while an important surrogate for efficacy of cancer treatment, is not equivalent to overall survival.
    • Specific to HCC, unlike the original RECIST.
    • Based on expert consensus and not yet validated against gold standard (pathologic examination of explanted livers), though widely used.
    • HCC patients undergo complex multimodal therapies, including systemic cytotoxic chemotherapy, targeted therapy like sorafenib, locoregional treatment like transarterial chemoembolization (TACE) and radioembolization with Y90), and surgical resection. Imaging criteria (versus traditional endpoints of morbidity and mortality) can more quickly identify patients who are not responding to therapy to help guide decisions about modification of therapy.
    • Offers improved accuracy over previous criteria for tumor response (WHO and RECIST), which were developed based on data from patients receiving cytotoxic chemotherapy only.
    • Accounts for tumor necrosis induced by treatment (which can be misinterpreted as living tumor by WHO classification).

    Diagnostic Result:

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    Next Steps
    Creator Insights
    Dr. Josep Llovet

    About the Creator

    Josep Llovet, MD, is a professor of medicine and founder and director of the Liver Cancer Program at Mount Sinai Hospital. He was the president, secretary and founder of the International Liver Cancer Association (ILCA) and Chairman of the European Clinical Practice Guidelines of management of liver cancer (EASL-EORTC). He is an active researcher investigating the pathogenesis and treatment of liver cancer.

    To view Dr. Josep Llovet's publications, visit PubMed

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    About the Creator
    Dr. Josep Llovet
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