{"entity":{"id":"quantitative-imaging-biomarkers","kind":"technology","name":"Quantitative imaging biomarkers (RECIST, PERCIST, SUV, ADC)","aka":["imaging biomarkers","response criteria","PERCIST","standardised uptake value","apparent diffusion coefficient","Deauville score","PI-RADS","QIBA"],"tldr":"The numbers pulled from scans that decide whether a cancer is shrinking, growing or dead: tumour diameters for RECIST, sugar uptake on PET, water movement on MRI; they run every trial and most clinic decisions, and they are only as good as the way the scan was taken.","summary":"What they measure. A scan is a picture, but a decision needs a number. Response criteria turn measurements into categories: RECIST 1.1 sums the longest diameters of up to five target lesions on CT or MRI and calls response, stable disease or progression from the percentage change; PERCIST does the same with the peak standardised uptake value of FDG on PET; the Deauville five-point scale reads FDG uptake in lymphoma against liver and blood pool; PI-RADS, LI-RADS and BI-RADS grade the probability of prostate, liver and breast cancer on multiparametric imaging; the apparent diffusion coefficient on diffusion MRI measures how freely water moves, which falls in dense tumour and rises when cells die; and dynamic contrast measures such as Ktrans track blood vessel leakiness. Radiomics adds hundreds of texture and shape features on top of these.\n\nWho uses them and what changes. Every oncology trial defines its endpoints with these criteria, so a RECIST progression call ends a treatment on trial and usually in clinic too. Deauville scores after two cycles decide escalation and de-escalation in Hodgkin lymphoma; PI-RADS decides who is biopsied; the Lugano criteria decide remission in lymphoma; PSMA-RADS and PERCIST are being written into radioligand and immunotherapy trials. Immunotherapy needed its own variant, iRECIST, because tumours can swell before they shrink.\n\nWhat limits them. Diameters ignore necrosis and cavitation; standardised uptake values shift with scanner, reconstruction, glucose level and time after injection; and readers disagree, which is why pivotal trials use blinded central review. The RSNA Quantitative Imaging Biomarkers Alliance publishes profiles setting the acquisition and analysis standards under which a measurement can be trusted to a stated precision. None of these measures needs new equipment; the cost is in standardising protocols and training readers.","status":"standard-of-care","asOf":"2026-09-17","links":[{"label":"European Journal of Cancer 2009: New response evaluation criteria in solid tumours, revised RECIST guideline (version 1.1)","url":"https://doi.org/10.1016/j.ejca.2008.10.026"},{"label":"RSNA Quantitative Imaging Biomarkers Alliance (QIBA)","url":"https://www.rsna.org/research/quantitative-imaging-biomarkers-alliance"}],"tags":[],"related":[],"cancers":["metastatic-cancer","hodgkin-lymphoma","non-hodgkin-lymphoma","prostate","hcc","breast-cancer","nsclc"],"sections":["imaging","diagnostics"],"technologies":["radiomics","radiogenomics","imaging-core-labs","pet-adapted-therapy","fdg-pet","mp-mri","mri","ct","pet","radiology-ai-screening","psma-pet","fes-pet","ct-body-composition-sarcopenia"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["recist","deauville","sensitivity-specificity"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"Standardised measurement of lesion size, tracer uptake, diffusion or perfusion on routinely acquired images, converted by validated criteria into response categories or risk scores with known reproducibility.","strengths":["Uses scans already acquired in routine care","Common language for trials and clinic","Standardisation profiles define achievable precision"],"limitations":["Size change lags biology and misses necrosis","Uptake and diffusion values vary with scanner and protocol","Reader disagreement, so trials need central review"],"since":2000},"route":"/technologies/quantitative-imaging-biomarkers/","neighbours":{"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"hcc","kind":"cancer","name":"Hepatocellular carcinoma","route":"/cancers/hcc/"},{"id":"hodgkin-lymphoma","kind":"cancer","name":"Hodgkin lymphoma","route":"/cancers/hodgkin-lymphoma/"},{"id":"metastatic-cancer","kind":"cancer","name":"Metastatic cancer (cancer that has spread)","route":"/cancers/metastatic-cancer/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"diagnostics","kind":"section","name":"Diagnostics & Biomarkers","route":"/fronts/diagnostics/"},{"id":"imaging","kind":"section","name":"Imaging","route":"/fronts/imaging/"}],"technology":[{"id":"radiology-ai-screening","kind":"technology","name":"AI in radiology","route":"/technologies/radiology-ai-screening/"},{"id":"ct","kind":"technology","name":"CT (computed tomography)","route":"/technologies/ct/"},{"id":"ct-body-composition-sarcopenia","kind":"technology","name":"CT body composition and sarcopenia measurement","route":"/technologies/ct-body-composition-sarcopenia/"},{"id":"fdg-pet","kind":"technology","name":"FDG PET","route":"/technologies/fdg-pet/"},{"id":"fes-pet","kind":"technology","name":"FES PET (oestrogen receptor imaging)","route":"/technologies/fes-pet/"},{"id":"imaging-core-labs","kind":"technology","name":"Imaging core labs and central review","route":"/technologies/imaging-core-labs/"},{"id":"mri","kind":"technology","name":"MRI","route":"/technologies/mri/"},{"id":"mp-mri","kind":"technology","name":"Multiparametric prostate MRI (PI-RADS)","route":"/technologies/mp-mri/"},{"id":"pet","kind":"technology","name":"PET (positron emission tomography)","route":"/technologies/pet/"},{"id":"pet-adapted-therapy","kind":"technology","name":"PET-adapted (response-adapted) therapy","route":"/technologies/pet-adapted-therapy/"},{"id":"psma-pet","kind":"technology","name":"PSMA PET","route":"/technologies/psma-pet/"},{"id":"radiogenomics","kind":"technology","name":"Radiogenomics: predicting radiation sensitivity from genes","route":"/technologies/radiogenomics/"},{"id":"radiomics","kind":"technology","name":"Radiomics","route":"/technologies/radiomics/"}],"term":[{"id":"deauville","kind":"term","name":"Deauville score and PET-adapted therapy","route":"/terms/deauville/"},{"id":"recist","kind":"term","name":"RECIST","route":"/terms/recist/"},{"id":"sensitivity-specificity","kind":"term","name":"Sensitivity and specificity","route":"/terms/sensitivity-specificity/"}]}}