# Deauville five-point scale

Source: https://onco.cc/terms/deauville-score/  
OnCo record `deauville-score` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A 1-to-5 score for how bright a lymphoma looks on PET compared with the liver; 1-3 is considered a complete metabolic response.

## Summary

1: no uptake; 2: ≤ mediastinum; 3: > mediastinum but ≤ liver; 4: moderately > liver; 5: markedly > liver or new lesions. Adopted in the Lugano classification (2014); the decision point in PET-adapted Hodgkin and DLBCL trials. Inter-reader agreement is good at the extremes and weaker for score 3 vs 4.

## Fields

- Kind: Term
- Last checked: 2026-09-07

## Notes

- What the scale cannot settle. A score of 3, uptake above the mediastinal blood pool but at or below the liver, is deliberately ambiguous and is treated as an adequate response in de-escalation trials and an inadequate one in escalation trials, so the same scan can lead to opposite decisions depending on the protocol. Inflammation, infection, granulomatous disease, brown fat and recent growth-factor support all take up the tracer, and indolent lymphomas are variably avid. The Lugano classification, which built PET-CT into staging for avid lymphomas, also removed the routine staging bone marrow biopsy for Hodgkin lymphoma and most diffuse large B-cell lymphoma (Cheson 2014, Barrington 2014).

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Deauville_Criteria
- Cheson et al., Lugano classification: recommendations for initial evaluation, staging and response assessment of Hodgkin and non-Hodgkin lymphoma (Journal of Clinical Oncology 2014): https://doi.org/10.1200/JCO.2013.54.8800
- Cheson et al., J Clin Oncol 2014: the Lugano classification for staging and response assessment in Hodgkin and non-Hodgkin lymphoma: https://doi.org/10.1200/JCO.2013.54.8800
- Barrington et al., J Clin Oncol 2014: the Imaging Working Group consensus on PET-CT in lymphoma and the five-point scale: https://doi.org/10.1200/JCO.2013.53.5229

## Connected records

- cancers: [Advanced-stage classical Hodgkin lymphoma (stage III to IV)](https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/), [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Early-stage classical Hodgkin lymphoma (stage I to II)](https://onco.cc/cancers/early-stage-classical-hodgkin-lymphoma/), [Follicular lymphoma](https://onco.cc/cancers/follicular-lymphoma/), [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/), [Mediastinal grey zone lymphoma](https://onco.cc/cancers/mediastinal-grey-zone-lymphoma/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/), [Primary mediastinal (thymic) large B-cell lymphoma](https://onco.cc/cancers/primary-mediastinal-b-cell-lymphoma/), [Relapsed and refractory classical Hodgkin lymphoma](https://onco.cc/cancers/relapsed-refractory-hodgkin-lymphoma/)
- technologies: [FDG PET](https://onco.cc/technologies/fdg-pet/), [PET-adapted (response-adapted) therapy](https://onco.cc/technologies/pet-adapted-therapy/)
- key papers: [Early positron emission tomography response-adapted treatment in stage I and II Hodgkin lymphoma: final results of the randomized EORTC/LYSA/FIL H10 trial](https://onco.cc/key-papers/paper-eortc-h10-pet-adapted-early-hodgkin-jco-2017/), [PET-adapted treatment for newly diagnosed advanced Hodgkin lymphoma (AHL2011): a randomised, multicentre, non-inferiority, phase 3 study](https://onco.cc/key-papers/paper-ahl2011-pet-adapted-treatment-advanced-hodgkin-lancet-oncol-2019/), [PET-guided treatment in patients with advanced-stage Hodgkin's lymphoma (HD18): final results of an open-label, international, randomised phase 3 trial by the German Hodgkin Study Group](https://onco.cc/key-papers/paper-ghsg-hd18-pet-guided-escalated-beacopp-lancet-2017/), [Positron emission tomography-guided treatment in early-stage favorable Hodgkin lymphoma: final results of the international, randomized phase III HD16 trial by the German Hodgkin Study Group](https://onco.cc/key-papers/paper-ghsg-hd16-pet-guided-early-favourable-hodgkin-jco-2019/), [Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification](https://onco.cc/key-papers/paper-cheson-j-clin-oncol/)
- trials: [AHL2011](https://onco.cc/trials/ahl2011/), [EORTC/LYSA/FIL H10](https://onco.cc/trials/eortc-h10/), [GHSG HD16](https://onco.cc/trials/hd16/), [GHSG HD18](https://onco.cc/trials/hd18/), [IELSG37](https://onco.cc/trials/ielsg37/), [RADAR](https://onco.cc/trials/radar-hodgkin/), [RATHL](https://onco.cc/trials/rathl/)
- roadmaps: [Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting](https://onco.cc/roadmaps/lymphoma-roadmap/)
- ideas: [A radiotherapy-free cure for early Hodgkin lymphoma that actually holds](https://onco.cc/ideas/lymphoma-ev-radiotherapy-free-early-hodgkin/), [Use circulating tumour DNA instead of the interim scan to decide what happens next](https://onco.cc/ideas/lymphoma-ev-ctdna-instead-of-the-interim-scan/)

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