mRECIST for HCC.pptxVIP

Modified RECIST (mRECIST) Assessment for Hepatocellular Carcinoma;Background;1980;World Health Organisation (WHO) criteria;WHO 标准 以肿瘤大小的变化作为判断疗效的标准;WHO疗效评价标准（1979年） ?二维（双径）测量 ?以最大径(a)及其最大垂直径(b)的乘积代表肿瘤面积 a×b; 2000年美国NCI等正式发表RECIST标准： 采用单径测量代替双径测量 保留WHO标准中的CR、PR、SD、PD概念 相比WHO标准，更精确、简便、重复性好，同时增加了治疗机会，进行全面评估，并引进了影像学新概念。;RECIST 标准： 单径测量法，以肿瘤最大径的变化来代表体积的变化;传统RECIST标准以肿瘤最大直径（包括存活肿瘤及坏死区域）判断疗效，而mRECIST标准以“存活肿瘤”作为评估对象;治疗前;RECIST = PD mRECIST = CR;RECIST = SD mRECIST = PR;介入后肝内靶病灶测量;RECIST = SD; mRECIST = PD;Modified RECIST（mRECIST??;2012 EASL/EORTC 临床实践指南：专家推荐mRECIST评价肿瘤缓解;ASSESSMENT OF TUMOR LESIONS AT BASELINE;Target lesions;To be selected as a target lesion using mRECIST, an HCC lesion should meet all the following criteria: ;HCC lesions previously treated with locoregional or systemic treatments may or may not be considered as suitable to be selected as target lesions for mRECIST: may: well-delineated area of viable (contrast enhancement in the arterial phase) tumor at least 1 cm in longest diameter may not: poorly demarcated exhibits atypical enhancement as a result of the previous intervention;Infiltrative-type HCC;Portal vein thrombosis;Porta hepatis lymph node;Pleural effusion and ascites;Unenhanced; 平扫期 动脉期 门静脉期;tumor response for target lesions;NONTARGET LESIONS RESPONSE;NEW LESIONS;The tiny lesion is smaller than 1 cm; therefore, it must be considered equivocal. ;Overall response assessment includes:evaluation of target lesions response, nontarget lesions response, and new lesions.;;mRECIST：CR?PD;Summary;Skimming news from European Radiology ;1;2;3;This is the end of my presentation. Thank you!