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Three-Dimensional Radiation Therapy Target Volume Definitions for Osteoarthritis-Consensus Statement of the
David Rene Steike1, Michael Heinrich Seegenschmiedt2, Richard Shaffer3
1Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany.
Summary
Standardized target volumes for low-dose radiotherapy in osteoarthritis pain management were defined by international experts. This consensus provides guidance for consistent treatment planning and future clinical studies.
Area of Science:
- Radiotherapy
- Orthopedics
- Medical Imaging
Background:
- Low-dose radiotherapy (LDRT) is a minimally invasive option for osteoarthritis (OA) pain.
- Standardized target volume definitions are currently lacking for LDRT in OA.
Purpose of the Study:
- To establish standardized, joint-specific target volume definitions for LDRT in OA.
- To provide practical guidance for consistent LDRT treatment planning in OA patients.
Main Methods:
- An international Delphi consensus process involving 15 institutions.
- Utilized a standardized CT dataset ('homunculus') for uniform anatomical reference.
- Defined Clinical Target Volumes (CTV) based on three-dimensional concepts.
Main Results:
- Target volumes incorporate inflammatory and OA-specific pathologies (effusion, cysts, sclerosis).
- CTV definition includes the joint capsule with patient-specific cranio-caudal extent.
- Joint-specific isocenter definitions enable precise 3D boundary determination.
Conclusions:
- This consensus offers practical guidance for standardized 3D target volume definition in OA radiotherapy.
- Accurate anatomical knowledge and precise delineation support consistent LDRT planning.
- Provides a basis for future clinical studies and validation of LDRT for OA.
