Deauville Score in Lymphoma: — What Each Number Means

Two references create a range rather than a single cutoff, which makes the scale more useful. The mediastinal blood pool is the low anchor — any uptake at or below it is clearly not concerning. The liver is the higher anchor that separates scores 3, 4 and 5 from each other. Using both means the scale can describe a spectrum from clearly normal to clearly abnormal, with an equivocal zone in between, rather than a simple yes-or-no that would miss the middle ground.

Not exactly. At an interim scan — taken partway through treatment — many guidelines treat score 3 as consistent with a good response for certain lymphomas, particularly Hodgkin lymphoma. At end-of-treatment assessment, whether score 3 is acceptable or concerning depends on the lymphoma type and the clinical guidance being applied. The number is the same at both time points; the clinical weight it carries differs. Your haemato-oncologist will tell you how to read it in your specific situation.

It means the radiologist has identified uptake above the threshold for active disease. What that means for your treatment is a separate question that only your haemato-oncologist can answer, because it depends on where the uptake is, how it compares to your previous scan, what lymphoma type you have, and what treatment you are on. A score of 4 or 5 is not an automatic instruction to change treatment. Please speak to your team before drawing any conclusions from the number alone.

PET-CT is an imaging tool, not a biopsy. FDG uptake can be elevated by infections, inflammation, healing tissue after chemotherapy, and normal variation — not only by active lymphoma. Score X exists precisely because some bright areas are clearly unrelated to the disease. For borderline results, your team may recommend a repeat scan or a biopsy rather than acting on a single result alone. The Deauville score is a standardised description of what the scan shows, not a direct measurement of lymphoma cells.

The score is assigned by a nuclear medicine physician or radiologist with specialist training in PET-CT interpretation. For borderline cases — particularly score 3 at a critical decision point, or an unexpected score 4 or 5 — it is entirely reasonable to ask your haemato-oncologist whether a second read from another specialist centre is appropriate. This is standard practice in lymphoma care and is not an unusual or difficult request to make.

Complete metabolic response, abbreviated CMR, is a standardised term from the Lugano Classification — the international framework used to assess lymphoma treatment response. A CMR is generally defined as a Deauville score of 1 or 2, and in some contexts a score of 3, depending on the lymphoma type and the guidance being applied. Your haemato-oncologist will tell you which response category your scan falls into and what that means for your ongoing care.