diff --git a/IRaCIS.Core.Application/Service/Common/Export/CDISCExportBaseModel.cs b/IRaCIS.Core.Application/Service/Common/Export/CDISCExportBaseModel.cs
index 596324c51..073ed414f 100644
--- a/IRaCIS.Core.Application/Service/Common/Export/CDISCExportBaseModel.cs
+++ b/IRaCIS.Core.Application/Service/Common/Export/CDISCExportBaseModel.cs
@@ -178,6 +178,8 @@ public class TU_TR_RSBaseModel
     /// </summary>
     public DateTime? LatestScanDate { get; set; }
 
+    public DateTime? EarliestScanDate { get; set; }
+
     /// <summary>
     /// eCRF标识 TUREFID  TRREFID  RSREFID
     /// </summary>
@@ -208,8 +210,22 @@ public class TU_TR_RSBaseModel
 
     public string IsJudgeSelectStr => IsJudgeSelect == true ? "Y" : "";
 
+    public bool IsTargetPD = false;
+
+    public bool IsOverallResponsePD = false;
+
+    //TR表  靶病灶PD了，访视层级的都是最早拍片日期  RS表 整体肿瘤评估PD了，那么疗效评估的拍片日期都给最早的
+    public bool IsPD => Domain == "TR" ? IsTargetPD : IsOverallResponsePD;
+
     public string ArmEnumStr { get; set; }
-    public string LatestScanDateStr => LatestScanDate != null ? LatestScanDate?.ToString("yyyy-MM-dd")! : "";
+    public string LatestScanDateStr
+    {
+        get
+        {
+            var date = IsPD ? EarliestScanDate : LatestScanDate;
+            return date?.ToString("yyyy-MM-dd") ?? "";
+        }
+    }
     public string TrialSiteSubjectCode => ResearchProgramNo + SubjectCode;
     #endregion
 }
diff --git a/IRaCIS.Core.Application/Service/Common/Export/RESISTExportService.cs b/IRaCIS.Core.Application/Service/Common/Export/RESISTExportService.cs
index 8384242ca..e28be0d9d 100644
--- a/IRaCIS.Core.Application/Service/Common/Export/RESISTExportService.cs
+++ b/IRaCIS.Core.Application/Service/Common/Export/RESISTExportService.cs
@@ -258,6 +258,7 @@ public class Tumor_CDISC_ExportService(IRepository<ReadingQuestionCriterionTrial
             VisitTaskNum = t.VisitTaskNum,
             VisitNum = t.VisitTaskNum,
             VisitName = t.SourceSubjectVisit.VisitName,
+            EarliestScanDate = t.SourceSubjectVisit.EarliestScanDate,
             LatestScanDate = t.SourceSubjectVisit.LatestScanDate,
             VisitTaskId = t.Id,
             CriterionName = t.TrialReadingCriterion.CriterionName,
@@ -449,7 +450,7 @@ public class Tumor_CDISC_ExportService(IRepository<ReadingQuestionCriterionTrial
 
 
 
-                foreach (var lessionAnswer in lesion.LessionAnswerList)
+                foreach (var lessionAnswer in lesion.LessionAnswerList.OrderBy(t => t.ShowOrder))
                 {
                     var trLessionIndex = -1;
 
@@ -560,6 +561,10 @@ public class Tumor_CDISC_ExportService(IRepository<ReadingQuestionCriterionTrial
                 {
                     var tr = CreatNewTRExport(task, tr_subjectIndexNoDic);
 
+                    //所有靶病灶的鉴定方法的合集，日期取访视点的影像日期（默认最晚日期，PD时取最早日期）
+                    tr.IdentificationMethod = string.Join(",", tuList.Where(t => t.VisitTaskId == tr.VisitTaskId && t.TumorIdentificationResult == "TARGET" && t.IdentificationMethod.IsNotNullOrEmpty()).Select(t => t.IdentificationMethod).Distinct());
+
+
 
                     //填充固定信息
                     Fill_TR_IndexValue(tr, trValueTypeIndex, trValueList);
@@ -630,6 +635,17 @@ public class Tumor_CDISC_ExportService(IRepository<ReadingQuestionCriterionTrial
 
                             rs.IsOveralResponse = true;
 
+                            rs.IsOverallResponsePD = rs.RespondEfficacyAssessment == "PD";
+
+                        }
+
+                        if (questionAnswer.QuestionType == QuestionType.TargetLesion && rs.RespondEfficacyAssessment == "PD")
+                        {
+                            //TR表  靶病灶PD了，访视层级的都是最早拍片日期
+                            foreach (var tr in trList.Where(t => t.VisitTaskId == rs.VisitTaskId && t.TRGRPID.IsNullOrEmpty() && t.ARM_TumorNo.IsNullOrEmpty()))
+                            {
+                                tr.IsTargetPD = true;
+                            }
                         }
 
                         var findTask = reReadingList.FirstOrDefault(t => t.UserName == rs.UserName && t.ArmEnum == rs.ArmEnum && t.VisitTaskNum == rs.VisitNum);