ISCL/USCLC/EORTC response in lymph nodes
| Response . | Lugano PET-CT–based response . | Lugano CT-based response . | ISCL/EORTC/USCCL . |
|---|---|---|---|
| CR | Complete metabolic response. Score 1, 2, or 3* with or without a residual mass on 5PS. | Target LNs†/nodal masses must regress to ≤1.5 cm LDi | All target LNs or nodal masses that previously were >1.5 cm are now ≤1.5 cm LDi by method used to assess size of LNs at baseline/screening or biopsy negative for lymphoma |
| PR | Partial metabolic response. Score of 4 or 5* with reduced uptake compared with baseline. | ≥50% decrease in SPD of up to 6 target measurable LNs. No clear increase in nonmeasured LNs or new LN >1.5 cm LDi. | Cumulative reduction >50% of the SPD of up to 6 target LNs and no new LN >1.5 cm LDi unless proven pathologically negative for lymphoma |
| SD | No metabolic response. Score of 4 or 5* with no significant change in FDG uptake from baseline. | <50% decrease from screening/baseline in SPD of up to 6 target measurable LNs. Criteria for PD not met. | Fails to meet criteria for CR, PR or PD |
| PD | Progressive metabolic disease. Score of 4 or 5* with an increase in intensity of uptake. | 1. Any LN of LDi >1.5 cm which has increased by ≥50% from PPD nadir 2. New LN >1.5 cm any axis 3. New or clear progression of preexisting nonmeasured LNs | 1. Any LN >1.5 cm LDi which has increased by ≥50% from PPD nadir 2. Any prior LN <1.5 cm LDi, which has increased by >50% from PPD nadir to >1.5 cm LDi |
| Response . | Lugano PET-CT–based response . | Lugano CT-based response . | ISCL/EORTC/USCCL . |
|---|---|---|---|
| CR | Complete metabolic response. Score 1, 2, or 3* with or without a residual mass on 5PS. | Target LNs†/nodal masses must regress to ≤1.5 cm LDi | All target LNs or nodal masses that previously were >1.5 cm are now ≤1.5 cm LDi by method used to assess size of LNs at baseline/screening or biopsy negative for lymphoma |
| PR | Partial metabolic response. Score of 4 or 5* with reduced uptake compared with baseline. | ≥50% decrease in SPD of up to 6 target measurable LNs. No clear increase in nonmeasured LNs or new LN >1.5 cm LDi. | Cumulative reduction >50% of the SPD of up to 6 target LNs and no new LN >1.5 cm LDi unless proven pathologically negative for lymphoma |
| SD | No metabolic response. Score of 4 or 5* with no significant change in FDG uptake from baseline. | <50% decrease from screening/baseline in SPD of up to 6 target measurable LNs. Criteria for PD not met. | Fails to meet criteria for CR, PR or PD |
| PD | Progressive metabolic disease. Score of 4 or 5* with an increase in intensity of uptake. | 1. Any LN of LDi >1.5 cm which has increased by ≥50% from PPD nadir 2. New LN >1.5 cm any axis 3. New or clear progression of preexisting nonmeasured LNs | 1. Any LN >1.5 cm LDi which has increased by ≥50% from PPD nadir 2. Any prior LN <1.5 cm LDi, which has increased by >50% from PPD nadir to >1.5 cm LDi |
Modified from Cheson et al.11
FDG, fluorodeoxyglucose; LDi, longest diameter; LN, lymph node; 5PS, 5-point scale; PD, progressive disease; SDi, short axis (longest perpendicular diameter to the LDi); SPD, sum of the products of the perpendicular diameters for multiple lesions
5PS: 1 = no FDG uptake > background; 2 = FDG uptake ≤ mediastinum; 3 = FDG uptake > mediastinum but ≤ liver; 4 = FDG uptake moderately > liver; 5 = FDG uptake markedly > liver and/or new lesions.
Target LNs are those >1.5 cm with representative abnormal node positive pathologically for lymphoma. In MF/SS, this is currently the LN classification of N3.