Three-Dimensional Treatment Planning and Target Volume Definition of Tendinitis and Bursitis—Consensus Statement of the International Benign Target Volume Group (IBTVG)

Weissmann T, Seegenschmiedt MH, Steike DR, Shaffer R, Kriz J, Pascher F, Thole AM, Linke F, Wimmer C, Colin G, Montero A, Alvarez B, de Lucas RH, Sotoca A, Ordonez SG, Cellini F, Reinartz G, Barron D, Koneru BN, Trombetta M, Eich HT (2026)

Publication Type: Journal article

Publication year: 2026

Journal

International Journal of Radiation Oncology Biology Physics Elsevier

DOI: 10.1016/j.ijrobp.2026.08.062

Abstract

Musculoskeletal disorders, particularly tendinitis and bursitis, are major contributors to global disability and health care burden. Low-dose radiation therapy (LDRT) has emerged as a promising treatment for refractory cases, demonstrating anti-inflammatory and antiproliferative effects, especially in inflammatory conditions. However, the lack of standardized treatment volumes hampers reproducibility, radiation safety, and broader clinical adoption. To address this gap, an international panel of experts applied the Delphi method to develop consensus-based target volumes for LDRT in common indications such as shoulder bursitis, lateral elbow tendinitis, trochanteric pain syndrome, Achilles tendinitis, and plantar fasciitis. Utilizing a standardized computed tomography-based homunculus, target volumes were delineated in a 3-dimensional Cartesian coordinate system to enable precise definition of gross tumor volume, clinical target volume, and planning target volume. Additionally, associated international statistical classification of diseases and related health problems version 10 (ICD-10) codes were defined to facilitate clinical documentation, billing, and future research. This structured approach provides a foundation for consistent treatment protocols, improved radiation protection, and future prospective trials to refine LDRT application in benign musculoskeletal conditions.

Authors with CRIS profile

Thomas Weissmann Department of Radiation Oncology

Involved external institutions

Bon Secours Mercy Health US United States (USA) (US) Loyola University Chicago US United States (USA) (US) Universitätsklinikum Münster DE Germany (DE) Bupa Cromwell Hospital GB United Kingdom (GB) Clemenshospital DE Germany (DE) Centre Hospitalier Universitaire de Liège (CHU Liège) BE Belgium (BE) HM Hospitales ES Spain (ES) Hospital Universitario Ramón y Cajal ES Spain (ES) Ruber International Hospital ES Spain (ES) Fondazione Policlinico Universitario Agostino Gemelli IRCCS IT Italy (IT) Drexel University US United States (USA) (US)

How to cite

APA:

Weissmann, T., Seegenschmiedt, M.H., Steike, D.R., Shaffer, R., Kriz, J., Pascher, F.,... Eich, H.T. (2026). Three-Dimensional Treatment Planning and Target Volume Definition of Tendinitis and Bursitis—Consensus Statement of the International Benign Target Volume Group (IBTVG). International Journal of Radiation Oncology Biology Physics. https://doi.org/10.1016/j.ijrobp.2026.08.062

MLA:

Weissmann, Thomas, et al. "Three-Dimensional Treatment Planning and Target Volume Definition of Tendinitis and Bursitis—Consensus Statement of the International Benign Target Volume Group (IBTVG)." International Journal of Radiation Oncology Biology Physics (2026).

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