Deauville Score 1–2: Complete Metabolic Response
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Question
A patient with non-Hodgkin lymphoma undergoes FDG PET/CT after 4 cycles of chemotherapy. The previously FDG-avid mediastinal mass now shows only minimal residual uptake comparable to surrounding blood pool activity. By Deauville criteria, this would be scored as:
- AScore 5 — progressive disease
- BScore 1-2 — complete metabolic response (CMR)
- CScore 4 — partial response
- DScore 3 — equivocal response
Show the answer and explanation
B. Score 1-2 — complete metabolic response (CMR)
The 5-point Deauville scale assesses FDG avidity relative to reference organs: Score 1 = no uptake; Score 2 = uptake ≤ mediastinal blood pool; Score 3 = uptake > mediastinal blood pool but ≤ liver; Score 4 = uptake moderately > liver; Score 5 = uptake markedly > liver or new lesions. Uptake comparable to or less than blood pool (Scores 1–2) after treatment represents a Complete Metabolic Response (CMR) and is associated with excellent prognosis. Deauville criteria are now standard for interim and end-of-treatment response assessment in FDG-avid lymphomas.
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