# Lugano — Lugano classification for lymphoma response

> Assesses lymphoma staging and treatment response.

**Situação:** vigente · **Órgão:** Oncologia · **Órgão emissor:** Lymphoma imaging consensus · **Versão:** 2014 · **Ano:** 2014

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: PET, CT
- Fonte primária: Cheson BD, Fisher RI, Barrington SF, et al.. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma (Lugano) (2014) — https://doi.org/10.1200/JCO.2013.54.8800
- Última verificação: 2026-06-26
- Última checagem: 2026-06-26

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| CMR | Complete metabolic response | Complete Metabolic Response: on FDG-PET, a Deauville 5-point score of 1, 2 or 3 (uptake at or below liver) at any residual mass, with no new FDG-avid disease; on CT, target nodes/nodal masses regress to <=1.5 cm in the longest transverse diameter, with no new lesions. | Indicates treatment success / no metabolically active disease; supports completing or de-escalating planned therapy and proceeding to surveillance per protocol. | Favourable response with strong prognostic value: in Hodgkin lymphoma a negative predictive value of ~95-100% (positive predictive value >90%) is reported, and ~80-100% NPV in aggressive non-Hodgkin lymphoma. | PMC4979083 (Cheson et al., 'Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification') Table 3 'Revised Criteria for Response Assessment', Complete Response row (PET 5PS score 1, 2 or 3; CT 'target nodes/nodal masses must regress to <=1.5 cm in LDi'); prognostic NPV/PPV figures from the PET response-assessment text | ✓ |
| PMR | Partial metabolic response | Partial Metabolic Response: on FDG-PET, a Deauville score of 4 or 5 but with reduced uptake compared with baseline (and, at interim, residual masses of any size); on CT, at least a 50% decrease in the sum of the products of perpendicular diameters (SPD) of up to 6 target measurable nodes/extranodal sites, with no new lesions and no progression. | At interim, reduced uptake (5PS 4-5 but lower than baseline) suggests chemo-sensitive disease and supports continuing therapy; at end of treatment, residual metabolically active disease warrants biopsy or a follow-up scan if further treatment is being considered. | Indicates residual disease; end-of-treatment PMR carries less favourable prognosis than CMR and requires confirmation of activity before changing management. | PMC4979083 Table 3 'Revised Criteria for Response Assessment', Partial Response row (PET 5PS score 4-5 with reduced uptake vs baseline; CT '>=50% decrease in SPD of up to 6 target measurable nodes'); management text on interim chemo-sensitivity and end-of-treatment biopsy/follow-up scan from the PET response-assessment text | ✓ |
| SD | No metabolic response | No Metabolic Response / Stable Disease: on FDG-PET, a Deauville score of 4 or 5 with no significant change in uptake from baseline; on CT, a less-than-50% decrease in the SPD of target lesions from baseline, without meeting any criterion for progressive disease. | Lack of meaningful response; prompts reassessment of the treatment strategy, with confirmation of residual disease (biopsy or repeat imaging) before any change as for residual PET-active disease. | Unfavourable response category — disease neither responding adequately nor formally progressing, conferring a poorer prognosis than metabolic response. | PMC4979083 Table 3 'Revised Criteria for Response Assessment', No Response or Stable Disease row (PET 5PS score 4-5 with no significant change from baseline; CT '<50% decrease from baseline in SPD ... no criteria for progressive disease met') | ✓ |
| PMD | Progressive metabolic disease | Progressive Metabolic Disease: on FDG-PET, a Deauville score of 4 or 5 with increased uptake intensity from baseline and/or new FDG-avid foci consistent with lymphoma; on CT, an individual node/lesion that grows (e.g. >=50% increase in SPD from nadir with the required absolute size increase) or the appearance of any new lesion. | Treatment failure; indicates a change of therapy (next-line/salvage regimen), with biopsy of new or progressing FDG-avid sites where confirmation is needed. | Worst response category — active, progressing lymphoma carrying the least favourable prognosis among the response groups. | PMC4979083 Table 3 'Revised Criteria for Response Assessment', Progressive Disease row (PET 5PS score 4-5 with increased intensity from baseline and/or new foci; CT individual node 'Increase by >=50% from PPD nadir' plus absolute size-increase criteria; new lesions) | ✓ |

### Citações por categoria
- **CMR**: Cheson BD, Fisher RI, Barrington SF, et al.. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma (Lugano) (2014) — https://doi.org/10.1200/JCO.2013.54.8800 · PMC4979083 (Cheson et al., 'Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification') Table 3 'Revised Criteria for Response Assessment', Complete Response row (PET 5PS score 1, 2 or 3; CT 'target nodes/nodal masses must regress to <=1.5 cm in LDi'); prognostic NPV/PPV figures from the PET response-assessment text
- **PMR**: Cheson BD, Fisher RI, Barrington SF, et al.. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma (Lugano) (2014) — https://doi.org/10.1200/JCO.2013.54.8800 · PMC4979083 Table 3 'Revised Criteria for Response Assessment', Partial Response row (PET 5PS score 4-5 with reduced uptake vs baseline; CT '>=50% decrease in SPD of up to 6 target measurable nodes'); management text on interim chemo-sensitivity and end-of-treatment biopsy/follow-up scan from the PET response-assessment text
- **SD**: Cheson BD, Fisher RI, Barrington SF, et al.. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma (Lugano) (2014) — https://doi.org/10.1200/JCO.2013.54.8800 · PMC4979083 Table 3 'Revised Criteria for Response Assessment', No Response or Stable Disease row (PET 5PS score 4-5 with no significant change from baseline; CT '<50% decrease from baseline in SPD ... no criteria for progressive disease met')
- **PMD**: Cheson BD, Fisher RI, Barrington SF, et al.. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma (Lugano) (2014) — https://doi.org/10.1200/JCO.2013.54.8800 · PMC4979083 Table 3 'Revised Criteria for Response Assessment', Progressive Disease row (PET 5PS score 4-5 with increased intensity from baseline and/or new foci; CT individual node 'Increase by >=50% from PPD nadir' plus absolute size-increase criteria; new lesions)

## Histórico de versões

| Data | Evento | Detalhe | Situação |
| --- | --- | --- | --- |
| 2014-09-01 | published | Lugano classification published. | confirmed |


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> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

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