An FDG PET-CT scan is performed in a patient with biopsy-proven mediastinal Hodgkin's lymphoma for staging. A mediastinal mass shows intense FDG uptake with SUVmax of 14. Two months after ABVD chemotherapy, a repeat PET-CT shows a residual mass but SUVmax has decreased to 2.0. According to Deauville criteria, this response would be scored as:

• A Deauville 1 — no residual uptake
• B Deauville 3 — uptake > mediastinal blood pool but ≤ liver ✓
• C Deauville 2 — uptake ≤ mediastinal blood pool (reference)
• D Deauville 4 — uptake moderately higher than liver

Explanation

The Deauville 5-point scale uses two reference sites — mediastinal blood pool (MBP, ~2.0 SUV) and liver (~3.0 SUV) — to score residual FDG activity. Deauville 1: no uptake; 2: ≤MBP; 3: >MBP but ≤liver; 4: moderately greater than liver; 5: markedly greater than liver or new lesions. An SUVmax of 2.0 equals the MBP, placing this between Deauville 2 and 3 — if equal to MBP it is scored 2; if slightly above MBP it is 3. Deauville 1–3 indicates complete metabolic response (CMR) in Hodgkin's lymphoma interim PET, allowing continuation of ABVD.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.