Reading your PET report
Deauville Score — What the Number on Your PET Report Means
Your lymphoma PET report contains a Deauville score — a number from 1 to 5 describing the level of metabolic activity the radiologist measured. Lower numbers mean less activity. Here is what each number means and how your oncologist reads it.
Medically reviewed by Dr. C. Raghavendra Reddy, Medical Oncologist, MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Last reviewed September 2026
- A five-point scale — The radiologist assigns a number based on FDG uptake compared to two reference points in your own body.
- Lower means less activity — Score 1 means no detectable uptake. Score 5 means markedly high uptake or new areas of activity.
- Timing changes how it is read — The same score carries different clinical meaning at mid-treatment compared to end of treatment.
- One piece of information — Your oncologist reads the Deauville score alongside your history and examination, not as a standalone result.
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The Deauville score is a five-point scale radiologists use to describe FDG uptake on a lymphoma PET scan. Score 1 means no detectable activity anywhere in the body. Score 5 means markedly high activity or new lesions. Your oncologist reads the number in the context of your full clinical picture and when in treatment the scan was taken.
What does each Deauville score mean?
- Score 1
- No FDG uptake above normal background levels anywhere in the body. No detectable metabolic activity in any lymph node or organ.
- Score 2
- Uptake is present but at or below the level of the mediastinum — the central chest area between the lungs, used as the lower reference point.
- Score 3
- Uptake is above the mediastinum but at or below the level of the liver. How this is read depends on when in your treatment the scan was taken.
- Score 4
- Uptake is moderately higher than the liver — above what is expected in normal liver tissue.
- Score 5
- Uptake is markedly higher than the liver, or there are new sites of activity not present on the previous scan.
- Score X
- Added alongside a number to flag that a site of uptake is probably not related to lymphoma — for example, inflammation from a recent infection or an injection site.
Which scores are considered a good response?
The Lugano classification, endorsed by both ESMO and NCCN, groups scores 1 and 2 as a complete metabolic response — no detectable activity above background. Score 3 is also generally read as complete response in most clinical situations, though your lymphoma type and scan timing affect how your oncologist interprets it.
Scores 4 and 5 indicate activity still measurable above the liver reference point. Whether a high score changes your treatment depends on whether this is a mid-treatment or end-of-treatment scan, and what your score was before.
No score is a verdict on its own. Your oncologist reads the Deauville result alongside biopsy findings, physical examination, and your history. Only they can tell you what your number means for your treatment.
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How does the Deauville score affect what happens next?
Does the score mean the same thing at every scan?
No. A score of 3 halfway through treatment may be read very differently from the same score after treatment ends. The protocols your oncologist follows — based on ESMO and NCCN guidance — specify what each threshold means at each stage. Ask your team whether your scan was an interim assessment or an end-of-treatment evaluation, because that distinction changes how the number is used.
What happens after a score of 4 or 5?
A high score opens a clinical conversation, not a conclusion. Your oncologist will want to know how the uptake compares to your baseline scan. Next steps may include continuing the current plan with closer monitoring, adjusting the treatment approach, or requesting a biopsy of the active site to confirm what is causing the uptake. Your team will explain which options apply to your situation.
What does it mean if my score went down between scans?
A falling score — for example from 4 to 2 — is generally a positive sign suggesting the lymphoma is responding metabolically to treatment. The clinical weight of that change depends on your lymphoma type, the protocol being used, and whether the score reached the threshold your oncologist was aiming for at that stage. Your oncologist will tell you whether the result was what they were looking for.
Why does the report use the liver and mediastinum as reference points?
Every PET scan varies slightly depending on how much radiotracer the body absorbs on a given day. Comparing uptake to fixed structures within the same body is more reliable than using absolute numbers across different scans. The mediastinum is the lower reference and the liver the upper, because both have stable, predictable uptake in healthy tissue. This is a radiological convention, not a comment on your liver.
Can a PET scan produce a misleading result?
Yes. False-positive results — uptake that turns out not to be active lymphoma — can occur with inflammation, infection, a recent biopsy, or a vaccination site. This is one reason oncologists sometimes request a biopsy before changing a treatment plan based on a scan alone. False negatives are less common but possible in slower-growing lymphomas. Your oncologist will tell you if confirmation is needed.
Is asking for a second opinion on the scan reading reasonable?
Yes, particularly when the result is unexpected, borderline, or would lead to a major change in treatment. There is genuine variation between expert readers on borderline Deauville scores. A second radiological opinion is a standard part of careful cancer care, not a sign of distrust. Ask your oncologist — they can arrange for the images to be reviewed at another centre.
Did you know?
Before the Deauville scale was adopted, radiologists described PET results in their own words, making it difficult to compare reports between centres or apply consistent thresholds in clinical trials.
Even with a shared scale, trained expert readers sometimes score the same scan differently — which is why borderline results are often reviewed at a multidisciplinary team meeting before any treatment decision is made.
Source: Lugano Classification for Response Assessment in Lymphoma, Journal of Clinical Oncology 2014
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Explore 94 more Understanding Your PET-CT Report topics
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
- 'Suspicious for Malignancy': How Certain Is That?
- How Long Does a PET-CT Report Take?
- How to Read Your PET-CT Report: A Section-by-Section Guide
- Should You Read Your Own PET-CT Report Before the Consult?
- TNM Staging on a PET-CT Report
- Why Your Report Mentions the Liver and Blood Pool
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
- Does a Suspicious PET Finding Always Need a Biopsy?
- Getting a Second Read of Your PET-CT Images
- How Often Is a PET-CT Scan Wrong?
- Muscle Uptake After Exercise or Injections
- Thymic and Rebound Uptake in Younger Patients
- Uptake After Radiotherapy: Inflammation or Disease?
- Uptake at a Biopsy or Surgery Site
- What Causes a False Negative on a PET Scan?
- What Causes a False Positive on a PET Scan?
- What Happens If Two Scans Disagree?
- Which Cancers Do Not Show Well on PET-CT?
- Why the Brain Always Lights Up on PET
Incidental Findings
- A Second Unrelated Cancer Found on PET-CT
- 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
- Can Tuberculosis Look Like Cancer on a PET Scan?
- Dental Infection and Jaw Uptake on PET
- Fungal Infection and Abscess on PET-CT
- How Long Should You Wait After an Infection Before a PET Scan?
- If It Might Be Infection, What Test Comes Next?
- Inflammation After Injections, Vaccines and Cannulas
- 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
- PET-CT for Vasculitis and Inflammatory Conditions
- Pneumonia and Recent Chest Infection on PET
- Sarcoidosis on PET-CT: The Great Mimic
- TB or Cancer? How Doctors Tell Them Apart
- Thyroid Uptake on PET: Diffuse vs Focal
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
- What Is a Deauville 3 and Why Is It Ambiguous?
- Why the Scan Says One Thing and You Feel Another
SUV Values Explained
- Comparing SUV Between Two Scans: Is It Meaningful?
- Does a Higher SUV Mean a More Aggressive Cancer?
- Factors That Change Your SUV Reading
- 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
- SUVmax, SUVmean and SUVpeak: What Is the Difference?
- 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
- Why Did My SUV Go Down but Not to Zero?
- Why Did My SUV Go Up After Treatment?
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Common questions
Frequently asked questions
What is a good Deauville score?
Per the Lugano classification, endorsed by ESMO and NCCN, scores 1 and 2 indicate complete metabolic response — no activity above background. Score 3 is generally also read as complete response in most clinical situations. Scores 4 and 5 indicate residual activity above the liver reference. Whether any score is favourable for you depends on your lymphoma type, scan timing, and previous result. Your oncologist will explain what your number means in your situation.
What does FDG uptake mean on a PET scan?
FDG is a radioactive tracer that behaves like sugar in the body. Cancer cells and some inflamed tissues absorb more of it than normal cells, appearing as brighter spots on the scan. The Deauville score describes how bright any suspicious area is compared to two reference points — the mediastinum and the liver — within your own body that day.
Can the Deauville score be used for all lymphoma types?
It was developed for Hodgkin lymphoma and is widely used in diffuse large B-cell lymphoma and other aggressive lymphomas. Its use in follicular and other indolent lymphomas is less standardised. Your oncologist will tell you whether Deauville scoring is the right framework for your type, and whether other measurements such as metabolic tumour volume are also being considered.
My report says 'complete metabolic response'. Does that mean I am cured?
No. Complete metabolic response is a scan-based term meaning no FDG-avid disease was detectable at the time of the scan. It describes what the PET showed that day, not the long-term outcome. Whether it translates to lasting disease control depends on the lymphoma type, treatment used, and other factors your team monitors over time. Your oncologist will explain what it means and what follows.
Why doesn't the report just say 'cancer active' or 'no cancer'?
PET scans measure metabolic activity, not cancer directly. High uptake can come from lymphoma, inflammation, infection, or a reactive process — the scan cannot always distinguish between them. A numbered scale conveys how much activity and where, which is more useful than a binary label and helps your team decide whether a biopsy is needed to confirm what the scan is showing.
What should I ask at my appointment after getting the PET result?
Ask specifically: what Deauville score was assigned, whether that score was what your oncologist was aiming for at this stage, and what it means for the next step. If you have had previous scans, ask how the current score compares. Writing the answers down or recording the conversation with permission helps — these appointments move quickly and the information is important.