The Lugano classification is a lymphoma staging system for non-Hodgkin and Hodgkin lymphoma. This article outlines the classification's response to treatment based on PET-CT.
Also included in the classification are staging and response to treatment based on CT.
Scoring system
The Lugano classification recommends the Deauville five-point scale for reporting response by FDG PET-CT:
- no uptake or no residual uptake (when used interim)
- slight uptake, but below blood pool (mediastinum)
- uptake above mediastinal, but below or equal to uptake in the liver
- uptake slightly to moderately higher than liver
- markedly increased uptake or any new lesion (on response evaluation)
Non-progressive disease
- complete metabolic response (CMR)
- score of 1, 2 or 3 in nodal or extranodal sites with or without a residual mass
- partial metabolic response (PMR)
- score of 4 or 5 with reduced uptake compared with baseline and residual mass(es) of any size
- stable disease or no metabolic response
- score of 4 or 5 with no obvious change in FDG uptake
Progressive disease
- score 4 or 5 in any lesion with an increase in intensity of FDG uptake from baseline (and/or new FDG-avid foci consistent with lymphoma)