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Three-Dimensional Radiation Therapy Target Volume Definitions for Osteoarthritis—Consensus Statement of the International Benign Target Volume Group
Journal article   Open access   Peer reviewed

Three-Dimensional Radiation Therapy Target Volume Definitions for Osteoarthritis—Consensus Statement of the International Benign Target Volume Group

David Rene Steike, Michael Heinrich Seegenschmiedt, Richard Shaffer, Thomas Weissmann, Jan Kriz, Felix Pascher, Anne-Marie Thole, Fraenze Linke, Caterina Wimmer, Gilles Colin, …
International journal of radiation oncology, biology, physics
22 Apr 2026
DOI: https://doi.org/10.1016/j.ijrobp.2026.04.005
PMID: 42031224
url
https://doi.org/10.1016/j.ijrobp.2026.04.005View
Published, Version of Record (VoR) Open CC BY V4.0

Abstract

Low-dose radiation therapy (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. 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 3-dimensional (3D) concept of the clinical target volume (CTV). A standardized computed tomography data set (“homunculus”) was used by all participants to ensure uniform anatomical reference for target volume delineation. 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 3D 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. This international consensus statement provides practical guidance for a standardized 3D target volume definition in the radiation therapy 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.

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