A patient with known Hodgkin's lymphoma undergoes 18F-FDG PET-CT for response assessment after 2 cycles of chemotherapy (interim PET). The Deauville score is assessed. A Deauville score of 1 or 2 at interim PET indicates:
- A Progressive disease — change chemotherapy regimen
- B Partial response — continue same regimen and reassess at end of treatment
- C Excellent metabolic response — associated with favourable prognosis (complete metabolic response) ✓
- D Indeterminate — repeat PET in 4 weeks
Correct answer: C. Excellent metabolic response — associated with favourable prognosis (complete metabolic response)
Explanation
The Deauville 5-point scale assesses FDG avidity relative to reference tissues: Score 1 = no uptake; Score 2 = uptake ≤ mediastinal blood pool; Score 3 = uptake > mediastinum but ≤ liver; Score 4 = uptake moderately > liver; Score 5 = markedly > liver or new lesions. At interim PET in Hodgkin's lymphoma, scores 1–2 indicate complete metabolic response (CMR) and excellent prognosis, allowing de-escalation of therapy. Scores 4–5 indicate a poor response and need for escalation. Score 3 is considered positive in most Hodgkin's trial protocols.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.