The Choi imaging criteria can provide insight about anti-tumor activity when other methods such as RECIST fail to demonstrate a response despite improved patient outcome. In the era of targeted drug therapy in oncology, it is critical to rely on imaging methods capable of assessing and reflecting the true response induced by such therapies, rather than the traditional anatomic size-based criteria such as RECIST 1.1. This is where the Choi criteria can play an important role.

By incorporating such measures into this new set of imaging criteria, in addition to simply measuring the size of a tumor, the Choi criteria were among the first to provide valuable insight into tumor behavior by more accurately determining tumor necrosis after treatment. Here we explore the Choi criteria’s history and applications.