Enhancing RAPNO: the need for standardized imaging heuristics and volumetric assessment

Finally, while volumetric analysis remains optional in RAPNO, there is a growing consensus on its added value for irregular, infiltrative, or multifocal tumors.For such tumors, tools that offer reliable subregion tracking, change detection, and spatial mapping of new lesions over time are essential for consistent reporting and trial readiness, [4].A natural progression from descriptive frameworks to quantitative, validated tools that are widely accessible grounded in robust imaging standards [5], is urgently needed.We commend the authors for providing a valuable resource and believe that the next phase of RAPNO development should be driven by practical, implementationready strategies.These approaches can enhance consistency across centers, improve reproducibility of imaging assessments, and ultimately support patient-level decision making in both clinical trials and routine care.