Lymphoma (staging)

Many lymphoma staging systems for both Hodgkin lymphoma and non-Hodgkin lymphoma have been developed.

The most widely used currently is the Lugano staging classification, which also separately defines criteria for response to treatment assessed by PET-CT or by CT alone. Patients having undergone immunomodulatory therapy may also be assessed by a modification of the Lugano criteria called LYRIC, which introduces the new category of "indeterminate response."

Classifications

Evolution of lymphoma staging and treatment response evaluation criteria:

• 1950: Peters three part system 
• 1966: Rye staging system 
• 1971: Ann Arbor staging system
• 1989: Cotswolds modifications of the Ann Arbor staging system with introduction of the use of computed tomography (CT)
• 1999: International Working Group Response Criteria: five clinical response categories based on lesions sizes
• 2007: International Harmonization Project Criteria: CT evaluation with additional use of relative qualitative evaluation F-18 FDG PET-CT
• 2009: Deauville five-point scale: qualitative evaluation with graduation of F-18 FDG uptake on PET-CT
• 2014: Lugano classification
• 2016: lymphoma response to immunomodulatory therapy criteria (LYRIC)