Deauville 5-point scale

Visual score comparing residual FDG uptake in Lymphoma sites to two reference tissues: mediastinal blood pool and liver.

Reference regions

Mediastinum: blood pool (typically ascending aorta)
Liver: usually right lobe (avoid focal lesions)

Scores (DS 1-5)

No uptake above background.
Uptake ≤ mediastinum.
Uptake > mediastinum but ≤ liver.
Uptake moderately > liver (diffusely or focally at sites of disease).
Uptake markedly higher than liver and/or new FDG-avid lesions typical for lymphoma.

Summary

Common exam-safe shorthand:

DS 1-3 usually = complete metabolic response (CMR)
DS 4-5 = residual active disease.

Caveat: “positive/negative” cut depends on context (interim vs end-of-treatment, histology, trial protocol).

Pitfalls and traps

Inflammation/infection, post-biopsy, radiotherapy change.
Thymic rebound (young), brown fat, muscle activity.
Marrow and splenic uptake after G-CSF or recent chemo.