Hamaoka et al proposed revised criteria for evaluating the therapeutic response in patients with metastatic bone tumors. This takes into account the availability of different imaging methods. The authors are from M.D. Anderson Cancer Center in Houston.
Imaging modalities:
(1) plain radiograph (X-ray)
(2) CT scan
(3) skeletal scintigraphy
(4) MRI
|
Plain Radiography |
Response |
|
complete sclerosis or fill-in of lytic lesions |
complete |
|
normalization of osteoblastic lesion |
complete |
|
sclerotic rim or partial fill in or sclerosis of lytic lesions |
partial |
|
sclerosis of a previously undetected lesion |
partial |
|
regression of measurable lesions |
partial |
|
decrease in blastic lesion |
partial |
|
no change in measurable lesions |
no change (stable disease) |
|
no change in blastic/lytic lesion |
no change (stable disease) |
|
increase in size of any existing measurable lesion |
progression |
|
new lesion |
progression |
|
increase in blastic/lytic lesion |
progression |
|
CT Scan |
Response |
|
complete sclerosis or fill-in of lytic lesions |
complete |
|
disappearance of tumor signal |
complete |
|
normalization of osteoblastic lesion |
complete |
|
sclerotic rim or partial fill in or sclerosis of lytic lesions |
partial |
|
sclerosis of a previously undetected lesion |
partial |
|
regression of measurable lesions |
partial |
|
decrease in blastic lesion |
partial |
|
no change in measurable lesions |
no change (stable disease) |
|
no change in blastic/lytic lesion |
no change (stable disease) |
|
increase in size of any existing measurable lesion |
progression |
|
new lesion |
progression |
|
increase in blastic/lytic lesion |
progression |
|
Skeletal Scintigraphy |
Response |
|
disappearance of hot spots |
complete |
|
regression of measurable lesions (after excluding rapid progression on CT or plain radiographs) |
partial |
|
new lesion (after excluding flare reaction) |
progression |
|
increase in activity (after excluding flare reaction) |
progression |
|
MRI |
Response |
|
disappearance of tumor signal |
complete |
|
regression of measurable lesions |
partial |
|
no change in measurable lesions |
no change (stable disease) |
|
no change in blastic/lytic lesion |
no change (stable disease) |
|
increase in size of any existing measurable lesion |
progression |
|
new lesion |
progression |
where:
• For partial response not every lesion need to have regressed, but there should be no new lesions.
Specialty: Hematology Oncology, Surgery, general
ICD-10: ,
