Deauville five-point scale
Updates to Article Attributes
The Deauville five-point scale (Deauville 5ps) is an internationally recommended scale for clinical routine and clinical trials using FDG-PET/CT in the initial staging and assessment of treatment respons in Hodgkin lymphoma (HL) and certain types of non-Hodgkin lymphomas (NHL).
Inclusions
FDG-PET/CT for staging and treatment response in both clinical routine and clinical trials using the Deauville 5ps is recommended in 2:
- Hodgkin lymphoma (HL), any type
- diffuse large B cellular lymphoma (DLBCL)
- Marginal zone NHL with aggressive transformation
- FDG-avid nodal lymphomas, essentially all histologic types except:
- chronic lymphocytic leukemia (CLL)
- small lymphocytic lymphoma
- lymphoplasmocytic lymphoma
- Waldenström´s macroglobulinaemia
- mycosis fungoides
whereas there have been proposed separate criteria for 2
- primary extranodal
and - cutaneous lymphomas
Usage
It is a simple tool based on visual interpretation of FDG-uptake. It takes advantage of two reference points of the individual patient, which have demonstrated relatively constant uptake on serial imaging. The two reference organs are the mediastinum (aka blood-pool) and the liver.
The scale ranges from 1 to 5, where 1 is best and 5 is the worst. Each FDG-avid (or previously FDG-avid) lesion is rated independently.
- no uptake or no residual uptake (when used interim)
- slight uptake, but below blood-pool (mediastinum)
- uptake above mediastinal, but below or equalling uptake in the liver
- uptake slightly higher than liver
- markedly increased uptake or any new lesion (on response evaluation)
Some authors also use
- X for any lesion not overtly attributable to lymphoma
Assessment of treatment respons
- Complete response (CR):Scores 1,2 or 3 together with absence of FDG-avid bone marrow lesion(s) are interpreted as complete metabolic response (CR), irrespective of a persistent mass on CT
- Partial response (PR):A Deauville score of 4 or 5, however:
- uptake decreased compared with baseline and
- absence of structural progression development on CT
- Stable disease (SD), also called no metabolic response:A Deauville score of 4 or 5 without significant change in FDG uptake from baseline.
- Progressive disease (PD):A Deauville score of 4 to 5 with increasing intensity compared to baseline or any interim scan and/or any new FDG-avid focus consistent with malignant lymphoma.
History and etymology
The scale was proposed in an international workshop attended by hematologists and nuclear medicine experts in Deauville, France in 2009 4-5.
-<li>FDG-avid nodal lymphomas, essentially <strong>all histologic types except</strong>:<ul>- +<li>FDG-avid nodal lymphomas, essentially all histologic types except:<ul>
-<a title="Chronic lymphocytic leukemia" href="/articles/chronic-lymphocytic-leukaemia">chronic lymphocytic leukemia</a> (CLL)</li>- +<a href="/articles/chronic-lymphocytic-leukaemia">chronic lymphocytic leukemia</a> (CLL)</li>
-<li>mycosis fungoides</li>- +<li><a title="Mycosis fungoides" href="/articles/mycosis-fungoides">mycosis fungoides</a></li>
-<li>primary extranodal and</li>- +<li>primary extranodal</li>
-</ul><p> </p><h4>History and etymology</h4><p>The scale was proposed in an international workshop attended by hematologists and nuclear medicine experts in <strong>Deauville</strong>, France in 2009 <sup>4-5</sup>. </p>- +</ul><h4>History and etymology</h4><p>The scale was proposed in an international workshop attended by hematologists and nuclear medicine experts in <strong>Deauville</strong>, France in 2009 <sup>4-5</sup>. </p>
Tags changed:
- oncology
- lymphoma