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mRECIST for Hepatocellular Carcinoma

mRECIST (Lencioni & Llovet, 2010; AASLD-JNCI refinement)

Applies the modified RECIST criteria for hepatocellular carcinoma, in which only the arterially enhancing (viable) portion of each target lesion is measured, to categorize response as CR, PR, SD or PD.

Also searched as: HCC · TACE · viable tumor · arterial enhancement · tumor response

Baseline sum of viable-tumor diameters

Sum of the longest enhancing (viable) diameters of all target lesions on arterial-phase imaging.

mm
Nadir sum of viable-tumor diameters on study

If omitted, the smaller of the baseline and current sums is used.

mm
Current sum of viable-tumor diameters
mm
No intratumoral arterial enhancement remains in any target lesion

When checked, the current viable sum is treated as 0 (complete devascularization).

Non-target lesion status
New lesion(s) >= 1 cm with typical HCC enhancement pattern

Arterial hyperenhancement with portal-venous/delayed washout; smaller or atypical findings are not yet classed as new HCC.

Information
Incomplete input
  • Please provide: baseline viable-tumor sum, current viable-tumor sum, non-target lesion status.

How this tool works

Because locoregional therapies such as chemoembolization and ablation can sterilize an HCC without shrinking it, mRECIST measures only the viable tumor - the component showing intratumoral arterial-phase enhancement on contrast CT or MRI. Complete response is the disappearance of all intratumoral arterial enhancement in every target lesion; partial response is at least a 30% fall in the sum of viable-tumor diameters versus baseline; progressive disease is at least a 20% rise (with a 5 mm absolute minimum in the AASLD-JNCI refinement) versus the smallest sum on study, or a new HCC lesion of at least 1 cm with typical enhancement. Portal vein tumor thrombus is considered non-measurable, and hilar nodes are considered pathological only at 20 mm or more in short axis. Atypical intrahepatic and extrahepatic lesions are measured by overall longest diameter as in standard RECIST 1.1.

References

Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.

Clinical questions that use this

Vetting guides that reach for this tool.

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