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Chest
Diagnosis
Pulmonary Neoplasms
Evaluation of Treatment Response
WHO Criteria
WHO Criteria
Brett W. Carter, MD, CPPS
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KEY FACTS

  • Terminology

    • Key Concepts

      • Clinical Implications

        TERMINOLOGY

        • Abbreviations

          • World Health Organization (WHO)

        • Definitions

          • WHO criteria published in 1979 and 1981
            • Attempted to standardize criteria recording and reporting of response, recurrence, and disease-free interval
            • Adopted as standard method for evaluating tumor response at that time
            • Introduced concept of assessing response to therapy by change in sum of products of diameters (SPD)
              • SPD: Longest overall tumor diameter and longest diameter perpendicular to longest overall diameter
          • WHO criteria have largely been replaced by more recent guidelines (such as response evaluation criteria in solid tumors [RECIST])
            • May be encountered in some clinical protocols

        • Rationale and Key Concepts

          • Identify measurable disease
          • No maximum number of lesions specified
          • Calculate and evaluate change in SPD

        IMAGING ANATOMY

        • Baseline Measurement Guidelines

          CLINICAL IMPLICATIONS

          • Reassessment

            • Evaluation of Overall Response

              • Confirmation of Response

                • Limitations of WHO Criteria

                  Selected References

                  1. Tirkes T et al: Response criteria in oncologic imaging: review of traditional and new criteria. Radiographics. 33(5):1323-41, 2013
                  2. Kang H et al: Imaging-based tumor treatment response evaluation: review of conventional, new, and emerging concepts. Korean J Radiol. 13(4):371-90, 2012
                  3. Jaffe CC: Measures of response: RECIST, WHO, and new alternatives. J Clin Oncol. 24(20):3245-51, 2006
                  4. Choi JH et al: Comparison of WHO and RECIST criteria for response in metastatic colorectal carcinoma. Cancer Res Treat. 37(5):290-3, 2005
                  5. Therasse P et al: RECIST vs. WHO: prospective comparison of response criteria in an EORTC phase II clinical trial investigating ET-743 in advanced soft tissue sarcoma. Eur J Cancer. 41(10):1426-30, 2005
                  6. Park JO et al: Measuring response in solid tumors: comparison of RECIST and WHO response criteria. Jpn J Clin Oncol. 33(10):533-7, 2003
                  Related Anatomy
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                  References
                  Tables

                  Tables

                  KEY FACTS

                  • Terminology

                    • Key Concepts

                      • Clinical Implications

                        TERMINOLOGY

                        • Abbreviations

                          • World Health Organization (WHO)

                        • Definitions

                          • WHO criteria published in 1979 and 1981
                            • Attempted to standardize criteria recording and reporting of response, recurrence, and disease-free interval
                            • Adopted as standard method for evaluating tumor response at that time
                            • Introduced concept of assessing response to therapy by change in sum of products of diameters (SPD)
                              • SPD: Longest overall tumor diameter and longest diameter perpendicular to longest overall diameter
                          • WHO criteria have largely been replaced by more recent guidelines (such as response evaluation criteria in solid tumors [RECIST])
                            • May be encountered in some clinical protocols

                        • Rationale and Key Concepts

                          • Identify measurable disease
                          • No maximum number of lesions specified
                          • Calculate and evaluate change in SPD

                        IMAGING ANATOMY

                        • Baseline Measurement Guidelines

                          CLINICAL IMPLICATIONS

                          • Reassessment

                            • Evaluation of Overall Response

                              • Confirmation of Response

                                • Limitations of WHO Criteria

                                  Selected References

                                  1. Tirkes T et al: Response criteria in oncologic imaging: review of traditional and new criteria. Radiographics. 33(5):1323-41, 2013
                                  2. Kang H et al: Imaging-based tumor treatment response evaluation: review of conventional, new, and emerging concepts. Korean J Radiol. 13(4):371-90, 2012
                                  3. Jaffe CC: Measures of response: RECIST, WHO, and new alternatives. J Clin Oncol. 24(20):3245-51, 2006
                                  4. Choi JH et al: Comparison of WHO and RECIST criteria for response in metastatic colorectal carcinoma. Cancer Res Treat. 37(5):290-3, 2005
                                  5. Therasse P et al: RECIST vs. WHO: prospective comparison of response criteria in an EORTC phase II clinical trial investigating ET-743 in advanced soft tissue sarcoma. Eur J Cancer. 41(10):1426-30, 2005
                                  6. Park JO et al: Measuring response in solid tumors: comparison of RECIST and WHO response criteria. Jpn J Clin Oncol. 33(10):533-7, 2003