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Intensity-modulated arc therapy: principles, technologies and clinical implementation
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2011 Phys. Med. Biol. 56 R31
(http://iopscience./0031-9155/56/5/R01)
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IOP PUBLISHING PHYSICS IN MEDICINE AND BIOLOGY
Phys. Med. Biol. 56 (2011) R31–R54 doi:-9155/56/5/R01
TOPICAL REVIEW
Intensity-modulated arc therapy: principles,
technologies and clinical implementation
Cedric X Yu and Grace Tang
University of Maryland School of Medicine, Baltimore, MD, USA
Received 20 September 2009, in final form 22 December 2010
Published 4 February 2011
Online at stacks./PMB/56/R31
Abstract
Intensity-modulated arc therapy (IMAT) was proposed by Yu (1995 Phys.
Med. Biol. 40 1435–49) as an alternative to tomotherapy. Over more than
a decade, much progress has been made. The advantages and limitations
of the IMAT technique have also been better understood. In recent years,
single-arc forms of IMAT have emerged and mercially adopted.
The leading example is the volumetric-modulated arc therapy (VMAT), a
single-arc form of IMAT that delivers apertures of varying weights with a
single-arc rotation that uses dose-rate variation of the treatment machine. With
commercial implementation of VMAT, wide clinical adoption has quickly taken
root. However, there remains a lack of general understanding for the planning
of such arc treatments, as well as what delivery limitations promises
are made. Commercial promotion petition add further confusion for
the end users. It is therefore necessary to provide a summary of this technology
and some guidelines on its clin