Evidence map›Paper›PMID 41678085›Full record

ArticleAnnals of nuclear medicine2026

Doughnut-shaped bone lesions on

Nathan D Aeschbacher, Alexander Maurer, Stephan Beintner-Skawran, Michael Messerli, Bert-Ram Sah, Philipp A Kaufmann, David Holzmann, Christian Meerwein, Lorenz Bankel, Tamara Rordorf and 7 more

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Article in Annals of nuclear medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

17 authors.

Nathan D AeschbacherDepartment of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland. nathan.aeschbacher@usz.ch.ORCID http://orcid.org/0009-0006-8344-314X
Alexander MaurerDepartment of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
Stephan Beintner-SkawranDepartment of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
Michael MesserliDepartment of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
Bert-Ram SahDepartment of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
Philipp A KaufmannDepartment of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
David HolzmannUniversity of Zurich, Zurich, Switzerland.
Christian MeerweinUniversity of Zurich, Zurich, Switzerland.
Lorenz BankelUniversity of Zurich, Zurich, Switzerland.
Tamara RordorfUniversity of Zurich, Zurich, Switzerland.
Nicolaus AndratschkeUniversity of Zurich, Zurich, Switzerland.
Panagiotis BalermpasUniversity of Zurich, Zurich, Switzerland.
Matthias GuckenbergerUniversity of Zurich, Zurich, Switzerland.
Joanna ManganaUniversity of Zurich, Zurich, Switzerland.
Daniela Mihic-ProbstUniversity of Zurich, Zurich, Switzerland.
Niels RuppUniversity of Zurich, Zurich, Switzerland.
Martin W HuellnerDepartment of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePseudoprogression (PP) is rarely observed in the skeleton. Over the past years, we have observed the appearance of unclassifiable, doughnut-shaped bone lesions in patients under immunotherapy. Our study aims to characterize these lesions under the hypothesis they may represent osseous PP.

methodsThis retrospective study included 714 patients under immune-checkpoint inhibitor (ICI) therapy, targeted therapy, chemotherapy or local radiotherapy (RT) for either malignant melanoma (mM), lung cancer (LC), oropharyngeal or nasopharyngeal cancer with annular bone lesions, who underwent 18F-fluorodeoxyglucose positron emission tomography / computed tomography (18F-FDG-PET/CT) at the University Hospital Zurich between January 2010 and November 2023. Characteristics of annular bone lesions, including 18F-FDG-PET/CT metrics, were recorded. A descriptive analysis was carried out.

resultsSix of the 714 patients demonstrated a new onset of 18F-FDG-avid doughnut-shaped bone lesions on 18F-FDG-PET/CT. Five patients were under ICI therapy and one patient was under RT. All lesions were transient and resolved on follow-up imaging. In two of six patients, histopathology samples were obtained and excluded malignancy. All ICI-treated patients demonstrated high 18F-FDG uptake of the lesions without corresponding abnormalities on computed tomography (CT). The mean time to lesion appearance after therapy initiation was 10.0 ± 8.1 months, and mean resolution occurred 7.7 ± 2.4 months after detection. All patients under ICI therapy exhibited additional immune-related changes.

conclusionNew, metabolically active doughnut-shaped bone lesions without clear CT correlates on 18F-FDG-PET/CT in patients receiving immunotherapy (or local RT) likely represent benign manifestations within the spectrum of PP rather than metastatic disease.

Indexed as

Disease ProgressionFluorodeoxyglucose F18ImmunotherapyPositron Emission Tomography Computed TomographyAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesFluorodeoxyglucose F18Bone neoplasmsDisease progressionLung neoplasmsMelanomaPositron emission tomography computed tomography

Identifiers

PMID41678085

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.