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Article History

Received: 17 April 2026

Accepted: 25 May 2026

First Online: 28 May 2026

Declarations

:

: The trial was approved by the local institutional review board (Ethics Committee II of Heidelberg University, Faculty of Medicine Mannheim) and the relevant German federal authorities prior to initiation and was registered at ClinicalTrials.gov (NCT03226483). All procedures were conducted in accordance with the Declaration of Helsinki.

: Written informed consent including consent for data publication was obtained from all individual participants included in the study.

: SB reports travel expenses and honoraria from Carl Zeiss Meditec AG outside the submitted work. GRS reports consulting fees, travel expenses and honoraria from Carl Zeiss Meditec AG and member of the ASTRO international committee outside the submitted work. FS reports travel expenses and honoraria from Carl Zeiss Meditec AG outside the submitted work. SC reports travel expenses consulting fees and honoraria from Carl Zeiss Meditec AG outside the submitted work. AMR reports grants from Deutsche Arthrose-Hilfe e.V.; honoraria from Carl Zeiss Meditec AG, Astra Zeneca, Guerbet SA; participation on Data Safety Monitoring or advisory board of INTRAGO-II study and awaits decision on pending patent EP4370202A1 outside the submitted work. ES reports honoraria and travel expenses from Carl Zeiss Meditec AG and is unpaid board member (Deutsche Gesellschaft für Biologische Strahlenforschung). FAG reports grants or contracts from Elekta AB, TME Pharma AG, Guerbet SA, Carl Zeiss Meditec AG and Varian Medical Systems; consulting fees from Carl Zeiss Meditec AG, TME Pharma AG, Cureteq AG, Novocure and Biotex Inc; honoraria from Astra Zeneca, Medac GmbH, Carl Zeiss Meditec AG and TME Pharma AG; travel expenses from Carl Zeiss Meditec AG, TME Pharma AG, Varian Medical Systems; stocks from TME Pharma AG, receipt of other service from TME Pharma AG and holds patents EP23000076.2, EP23000075.4 and US10857388B2 outside the submitted work. The other authors report no conflicts of interest (NE, AS, SW, YA).