PET scan reporting
Deauville Score 1 to 5: — The Lymphoma Scale Explained
When your PET scan report includes a Deauville score, it is a standardised number that tells your oncologist how much lymphoma activity, if any, is still visible. Understanding what each number means helps you follow the conversation with your team.
Medically reviewed by Dr. C. Raghavendra Reddy, Medical Oncologist, MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Last reviewed September 2026
- A standardised reading — Every centre using Deauville reads PET scans against the same reference point — the liver — so results are consistent across hospitals.
- Used at two key moments — Your team may check it mid-treatment and again at the end. The same number can mean different things at each of those points.
- Scores 1–3 are generally favourable — These indicate no significant residual metabolic activity, or activity below the level that concerns your team.
- Scores 4–5 need closer review — Higher scores do not automatically mean treatment has failed, but they prompt further assessment before any decision is made.
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The Deauville score is a 5-point scale radiologists use to read PET scans in lymphoma. Scores 1 and 2 are clearly favourable. Score 3 is generally considered a response. Scores 4 and 5 indicate remaining metabolic activity and need a closer look. Your oncologist explains what the score means for your specific situation.
What is the Deauville score and why does it appear on your PET report?
The Deauville score is a 5-point scale that radiologists use to report how much metabolic activity remains in your lymphoma after treatment. It is the international standard used within the Lugano criteria, which ESMO and NCCN both endorse and which most lymphoma centres worldwide follow.
The scale uses the liver as a reference point. Each score compares whatever uptake appears in the scan to the level of activity normally seen in healthy liver tissue — a fixed biological marker that is consistent from one centre to the next.
You may see it on an interim PET taken mid-treatment, or on an end-of-treatment PET taken after all planned treatment is finished. The same score carries different weight at each of those points, and your oncologist reads it in that context.
What should you know when you receive your Deauville result?
- Ask your oncologist whether this was an interim PET or an end-of-treatment PET — the same score is read differently depending on the timing.
- If the report includes terms such as 'complete metabolic response' or 'partial metabolic response', ask what those mean for your next steps.
- A score of 4 or 5 does not automatically mean treatment has failed. Ask what happens next before drawing your own conclusion.
- Keep the report or its reference number. Your oncologist compares every new scan to earlier ones, so each result is a record you may need again.
- The number alone does not decide anything. Your oncologist reads it alongside your clinical picture, previous scans, and lymphoma type.
What do the terms on a lymphoma PET report mean?
- Complete metabolic response (CMR)
- The scan shows no significant residual lymphoma activity. Typically corresponds to a Deauville score of 1, 2, or 3.
- Partial metabolic response (PMR)
- Activity has reduced since the last scan but is still present. Often corresponds to a score of 4 that is lower than the baseline reading.
- No metabolic response (NMR)
- Activity has not changed meaningfully from the previous scan. Usually corresponds to a score of 4 or 5 without clear reduction.
- Progressive metabolic disease (PMD)
- Existing areas of disease are more active than before, or new sites have appeared. Typically a score of 5 with new or worsening lesions.
- Lugano criteria
- The international framework for assessing lymphoma treatment response, endorsed by ESMO and NCCN. The Deauville score is the PET reading tool within this framework.
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What does each Deauville score mean, 1 through 5?
| Score | What the scan shows | Response category (Lugano criteria) |
|---|---|---|
| 1 | No uptake visible anywhere in the body | Complete metabolic response |
| 2 | Uptake at or below the level of the mediastinum (centre of the chest) | Complete metabolic response |
| 3 | Uptake above the mediastinum but at or below the liver | Complete metabolic response at end-of-treatment in most types; timing matters at interim |
| 4 | Uptake moderately above the liver | Partial or no response — further review needed |
| 5 | Uptake markedly above the liver, or new lesions anywhere in the body | Progressive or no response — close assessment required |
What happens if your score is 4 or 5?
Scores 4 and 5 mean the scan has shown metabolic activity above the level your team considers a response. That is the point at which your oncologist looks more carefully before deciding on next steps.
A higher score does not automatically mean active lymphoma. Scar tissue and treatment-related inflammation can appear active on a PET scan without being live disease. Your team may recommend a biopsy of the area to confirm what the activity represents before making any change to your treatment.
What happens next depends on where the scan falls in your treatment timeline, how the activity compares to your previous scan, and your overall clinical picture. Only your oncologist can read that combination for you.
Did you know?
The Deauville scoring system has been used in major international lymphoma trials and is built into the response criteria that most oncology centres worldwide now follow.
Using the liver as a shared biological reference point is what makes results comparable from one hospital to another — the score means the same thing wherever it is read.
Source: Lugano Classification — International Conference on Malignant Lymphomas, 2014; endorsed by ESMO and NCCN
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Explore 94 more Understanding Your PET-CT Report topics
Response Assessment Scores & Criteria
- Complete Metabolic Response: What It Means
- Deauville Score 1 to 5: The Lymphoma Scale Explained
- End-of-Treatment PET Scan: What It Decides
- How Doctors Judge Whether Treatment Is Working on PET-CT
- Interim PET Scan During Chemotherapy: Why It Is Done
- Metabolic Response vs Size Response: Why They Differ
- PERCIST Criteria: How Metabolic Response Is Measured
- Partial Metabolic Response: Is That Good Enough?
- Progressive Metabolic Disease: What Happens Next
- RECIST vs PERCIST: Size vs Activity
- Stable Metabolic Disease: Good News or Bad?
- Tumour Flare and Pseudoprogression on PET
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- Why the Scan Says One Thing and You Feel Another
False Positives, False Negatives & Pitfalls
- Bladder, Kidney and Ureter Activity on PET
- Bone Marrow Uptake After Growth Factor Injections
- Bowel Uptake: Normal, Inflammation or Something Else?
- Brown Fat Uptake: A Common Cause of Confusing Findings
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- What Happens If Two Scans Disagree?
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- Why the Brain Always Lights Up on PET
Incidental Findings
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- An Incidental Bone Finding on PET-CT
- An Incidental Breast Finding on PET-CT
- An Incidental Kidney or Adrenal Finding
- An Incidental Liver Lesion on PET-CT
- An Incidental Lung Nodule Found on PET-CT
- An Incidental Prostate Finding on PET-CT
- An Incidental Thyroid Nodule on Your PET Scan
- Do All Incidental Findings Need Investigation?
- Focal Bowel Uptake: Could It Be a Polyp?
- Incidental Findings on a PET-CT Scan: What They Are
- Incidental Heart Findings on a Cancer PET Scan
- The Cost of Chasing an Incidental Finding
- What to Ask Your Doctor About an Incidental Finding
Infection, TB & Inflammation on PET
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- Old Healed TB and Calcified Nodes on PET-CT
- PET-CT for Fever of Unknown Origin
- PET-CT for Suspected Infection in Implants and Prostheses
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Reading Your Report: Core Terms
- 'Cannot Be Excluded' and Other Cautious Phrases
- 'Deauville Score' on a Lymphoma PET Report
- 'FDG Avid': What It Means on Your Report
- 'Hypermetabolic': What the Word Actually Means
- 'Hypometabolic' and 'Photopenic' Findings
- 'Impression' vs 'Findings': Which Section Should You Read?
- 'Interval Change' and 'Stable Since Previous Study'
- 'Krenning Score' on a DOTANOC or DOTATATE Report
- 'Lymphadenopathy' on Your PET Report
- 'Metabolically Active Disease': What It Tells You
- 'Metastasis' and 'Distant Spread' on Your Report
- 'Mildly FDG Avid' vs 'Intensely FDG Avid'
- 'No Abnormal FDG Uptake': Is That a Clear Scan?
- 'Physiological Uptake': Normal Areas That Always Light Up
- 'Residual Disease' vs 'Complete Metabolic Response'
- 'Sub-Centimetre Node' and Why Size Matters on PET
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- How Long Does a PET-CT Report Take?
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SUV Values Explained
- Comparing SUV Between Two Scans: Is It Meaningful?
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- High SUV but Not Cancer: When the Number Misleads
- Is My SUVmax of 4 High? Reading Your Specific Number
- Low SUV but Still Cancer: The PET-Negative Cancers
- SUV in Non-Cancer Conditions
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- What Is SUV on a PET Scan?
- What Is a Normal SUV Value?
- What SUV Value Indicates Cancer?
- Why Blood Sugar Changes Your SUV Result
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- Why Did My SUV Go Up After Treatment?
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Common questions
Frequently asked questions
Is a Deauville score of 3 good or bad?
Score 3 is generally considered a response, and at the end of treatment it is often read as a complete metabolic response in most lymphoma types. At a mid-treatment interim scan, some protocols treat score 3 as needing escalation and others do not — it depends on the specific lymphoma type and the treatment guideline your team is following. Ask your oncologist directly which interpretation applies to your scan and your treatment.
Can a score of 4 or 5 be a false alarm?
Yes, and this is one reason a biopsy is often recommended before changing treatment on the basis of a high score alone. Inflammation, infection, or treatment-related tissue changes can produce increased PET activity that is not active lymphoma. A high Deauville score tells your team where to look more carefully, not what the answer is. If your oncologist has recommended a biopsy after a high score, that is them being thorough rather than assuming the worst.
What is the difference between an interim PET and an end-of-treatment PET?
An interim PET is taken part-way through your treatment, often after the first few cycles, and gives an early signal about whether the lymphoma is responding. An end-of-treatment PET is taken after all planned treatment is finished and reflects the final result. The same Deauville score carries more weight at the end of treatment because it describes an outcome rather than a direction of travel.
Does a score of 1 mean the lymphoma is cured?
A score of 1 means no residual metabolic activity was visible on that scan — it is the best possible PET result. Whether that corresponds to long-term remission depends on your lymphoma type, the treatment you received, and many other factors your oncologist weighs together. PET scans can miss very small numbers of cells below their detection threshold, so follow-up remains important even after the best scan result.
Will my Deauville scores be compared across all my scans?
Yes. Each PET report and its Deauville score becomes part of your permanent medical record. Your oncologist uses the series of scores over time — not just the most recent one — to understand how your lymphoma has responded and how to plan follow-up. If your situation changes later, those earlier scores are the baseline every new scan is read against.
The report mentions a liver reference — what does that mean?
The Deauville scale uses the liver as a biological reference because healthy liver tissue has a predictable level of metabolic activity on a PET scan. Radiologists compare whatever they see in lymphoma sites against that liver background. A score of 3 means the activity is at or below the liver level; a score of 4 means it is moderately above. Using a built-in biological reference is what makes the result consistent from one centre to the next.