Three-dimensional radiotherapy target volume definitions for osteoarthritis - Consensus statement of the International Benign Target Volume Group (IBTVG). - 2026
Three-dimensional radiotherapy target volume definitions for osteoarthritis - Consensus statement of the International Benign Target Volume Group (IBTVG).
Steike, David Rene; Seegenschmiedt, Michael Heinrich; Shaffer, Richardet al.
2026 • In International Journal of Radiation, Oncology, Biology, Physics
[en] [en] PURPOSE: Low-dose radiotherapy (LDRT) is a minimally invasive treatment option for pain management in selected patients with osteoarthritis (OA). However, standardized and internationally accepted target volume definitions are still lacking.
METHODS: An international expert consortium of 15 institutions from Europe and the United States conducted a Delphi consensus process to define joint-specific target volumes based on the three-dimensional concept of the Clinical Target Volume (CTV). A standardized CT dataset ("homunculus") was used by all participants to ensure uniform anatomical reference for target volume delineation.
RESULTS: Target volume definition includes inflammatory and OA-specific pathological features such as joint effusion, cysts, and subchondral sclerosis. The CTV encompasses the joint capsule and varies in its cranio-caudal extent among individual patients. Using joint-specific isocenter definitions - such as the midpoint between the femoral condyles for the knee joint - the three-dimensional boundaries of the CTV can be determined. This approach enables anatomically precise delineation of the target volume, ensuring inclusion of inflammation-relevant structures while excluding uninvolved bone and soft tissue.
CONCLUSION: This international consensus statement provides practical guidance for a standardized three-dimensional target volume definition in the radiotherapy of OA. Accurate knowledge of joint anatomy and pathology, combined with precise target volume delineation and careful consideration of the clinical context, such as symptom distribution and the pattern of joint involvement, may support more consistent LDRT treatment planning for OA. These target volume definitions also provide a structured basis for future clinical studies and further clinical validation.
Disciplines :
Human health sciences: Multidisciplinary, general & others
Author, co-author :
Steike, David Rene ; Department of Radiation Oncology, University Hospital Muenster, Germany. Electronic address: Davidrene.steike@ukmuenster.de
Seegenschmiedt, Michael Heinrich ; Department of Radiation Oncology, University Hospital Muenster, Germany, Radiotherapy, MVZ Ruhrradiologie Rue191 Essen, Essen, Germany, RadioOnkologieNetzwerk, Radiation Therapy Osnabrueck, Germany, RadioOnkologieNetzwerk, Radiation Therapy Ostalb, Germany, RadioOnkologieNetzwerk, Radiation Therapy Schwäbisch Gmünd, Germany
Shaffer, Richard; GenesisCare UK, Department of Radiation Oncology, Cromwell Hospital, 164-178 Cromwell Rd, Kensington, London SW5 0TU, United Kingdom
Weissmann, Thomas; Department of Radiation Therapy, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuernberg, Germany
Kriz, Jan; Department of Radiation Therapy, Alexianer Clemenshospital Muenster, Germany
Pascher, Felix; Department of Radiation Therapy, Alexianer Clemenshospital Muenster, Germany
Ordonez, GomezSilvia; Clinic for Radiation Oncology, Stadtspital Zurich, Switzerland
Cellini, Francesco; Department of Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS Rome, Italy
Reinartz, Gabriele; Department of Radiation Oncology, University Hospital Muenster, Germany
Barron, David; Bon Secours Mercy Health, Ohio, USA
Koneru, Bobby Nagendra; FHN/Leonard Ferguson Cancer Center, Freeport, Illinois, Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, Illinois, USA
Trombetta, Mark; Division of Radiation Oncology, Allegheny General Hospital, Drexel University College of Medicine, Pittsburgh, PA, USA
Eich, Hans Theodor; Department of Radiation Oncology, University Hospital Muenster, Germany
Three-dimensional radiotherapy target volume definitions for osteoarthritis - Consensus statement of the International Benign Target Volume Group (IBTVG).
Publication date :
22 April 2026
Journal title :
International Journal of Radiation, Oncology, Biology, Physics
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