A prospective trial of volumetric intensity modulated arc therapy vs conventional intensity modulated radiation therapy in advanced head and neck cancer. The purpose of this study was to compare single arc volumetric modulated arc therapy vmat to intensity modulated radiotherapy imrt for spine sbrt in terms of target coverage, organ at risk oar sparing and delivery performance. Volumetric modulated arc therapy for advanced pancreatic. Volumetric modulated arc therapy vmat is a radiotherapy technique in which the gantry rotates while the. Rapidarc ra is a type of dynamic imrt that involves application of a rotation beam according to ottos rotation theory of intensity modulated radiation therapy. The main purpose of this study is to perform the dosimetric comparison between intensity modulated radiation therapy imrt and volumetric modulated arc therapy vmat for the prostate cancer by using dose volume histograms dvh. Ultrafast treatment plan optimization for volumetric. Full text volumetric modulated arc therapy for treatment of. Beam complexity and monitor unit efficiency comparison in two. Pdf application of volumetric modulated arc therapy vmat. Pdf a retrospective planning analysis comparing intensity. A fast optimization approach for treatment planning of volumetric. Wang c, luan s, tang g, chen dz, earl ma, yu cx, 2008 arc.
The plans for imrt with nine fixed beams were compared against double modulated arcs with a single isocenter. Improvements in patient care achieved through imageguided positioning and plan adaptation have. Nov 01, 2009 double arc vmat improved results compared to ssimrt and single arc vmat in the majority of the evaluated target and oar dose parameters. An efficient method for volumetric intensity modulated arc therapy vmat planning was developed, where a single arc 360 degrees or less is delivered under continuous variation of multileaf collimator mlc segments, dose rate, and gantry speed. Application of volumetric modulated arc therapy vmat in a. The leading example was the volumetric modulated art the rapy, a single arc form of imat that delivers apertures of varying weightings with a single arc rotation using dose rate variation of the treatment machine. Fungkeefung sd, hackett r, hales l, warren g, singh ak. Dosimetric study of threedimensional conformal radiotherapy. The planning objectives for the planning target volume were a minimal dose of 95% and maximal dose of. Currently there are three mechanical variables in vmat delivery. An introduction to the intensitymodulated radiation therapy imrt.
Dosimetric comparison between the intensity modulated. The dynamic sliding window method with fixed gantry angle was utilized in intensity modulated radiation therapy imrt plans. Intensity modulated radiation therapy versus volumetric. Fontenot jd, king ml, johnson sa, wood cg, price mj, lo kk. Intensity modulated radiation therapy imrt and volumetric modulated arc therapy vmat are two commonly used ebrt techniques to treat cancer. 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 doserate variation of the treatment machine. Most re cently, there has been considerable interest in the rotating gantry imrt techniques, tomotherapy and volumetricmodulated arc therapy. Development and evaluation of an efficient approach to. The technique is similar to tomotherapy in that a full 360 deg of beam directions are available for optimization but is fundamentally different in that the entire dose. Treatment of lung cancer using volumetric modulated arc therapy. Volumetric modulated arc therapy vmat proposed by otto is an emerging treatment paradigm. Treatment planning for volumetric modulated arc therapy. Aug 22, 20 the advanced developments in external beam radiation therapy ebrt over the past few decades have improved dose conformity to the target while minimizing dose to the surrounding organs at risk oar. Two imrt segments are created per gantry angle to achieve a higher modulation as compared to just one segment and keep the amount of leaf travel within an.
Endometrial cancer, helical tomotherapy, intensity modulated radiation therapy, volumetric modulated arc therapy background endometrial cancer is one of the most common gynecologic cancers in the world. Volumetric modulated arc therapy international journal of. Volumetric modulated arc therapy vmat is an advancement of intensity modulated radiation therapy imrt which allows irradiation with simultaneously varying dose rate, gantry speed, collimator, and leaf positions. Apr 03, 2012 the general approach has come to be known as volumetric modulated arc therapy vmat. Is a single arc sufficient in volumetric modulated arc therapy vmat for complexshaped target volumes. Research article open access smartarcbased volumetric. Original article a retrospective planning analysis comparing intensity modulated radiation therapy imrt to volumetric modulated arc therapy vmat using two optimization algorithms for the treatment of earlystage prostate cancer craig a. A recently described novel approach for volumetric modulated arc therapy enables imrtlike dose distributions to be delivered using a single rotation of the gantry 10. Jun 24, 2010 a planning study evaluated if volumetric modulated arc therapy rapidarc ra could be used as an alternative to imrt in such cases. Imat is a rotational intensity modulated radiation therapy imrt which can be delivered using conventional linear accelerator with conventional ulti leaf collimators mlc. Volumetric modulated ark and dynamic conformal ark in sbrt 839 jbuon 2019.
Volumetric modulated arc therapy vmat is considered as. Volumetric modulated arc therapy nfrmc cancer center. The capability of vmat to reduce heart and cord dose, while maintaining lung receiving 20 gy,20%, was evaluated for. To compare stepandshoot intensitymodulated radiotherapy ssimrt with volumetricmodulated arc therapy vmat for complexshaped. Volumetric modulated arc therapy planning for distal. The biggest appeal of vmat is the reduction in treatment times compared to traditional imrt, since there is no wasted time, as gantry rotation, mlc movement and radiation delivery all happen simultaneously. Intensity modulated radiation therapy, protons, and the risk of second cancers. Commissioning of volumetric modulated arc therapy vmat in a. Safety and outcomes of volumetric modulated arc therapy in. Apr 01, 2011 volumetric modulated arc therapy vmat is an advancement of intensity modulated radiation therapy imrt which allows irradiation with simultaneously varying dose rate, gantry speed, collimator, and leaf positions. The technique is similar to tomotherapy in that a full 360 deg of beam directions are available for optimization but is fundamentally different in that the entire dose volume is delivered in a single source rotation.
Both imrt and vmat plans were chosen for the patients. Vmat plans relative to the standard intensitymodulated radiotherapy imrt approach in prostate cancer. Single arc volumetricmodulated arc therapy is sufficient for. The dose result of both intensity modulated radiation therapy imrt and smartarcbased volumetric modulated arc therapy vmats for ear gy the mean left middle ear doses were 39. The new technique is referred to as volumetric modulated arc therapy vmat. Dualisocentric volumetric modulated arc therapy in. For prostate cancer and vertebral metastases single arc vmat led to similar plan quality as. Dosimetric comparison of the helical tomotherapy, volumetric. Aug 01, 2014 cumulative dose volume histograms of clinical target volume 50 ctv 50 tomato, ctv 66 red, planning target volume 50 g y ptv 50 light blue, ptv 66 blue, lung green, heart orange, and spinal cord purple for one patient obtained in fixedfield intensity modulated radiotherapy imrt dashed lines and volumetric modulated arc.
Doublearc volumetric modulated therapy improves dose. Is a single arc sufficient in volumetricmodulated arc. Modulated arc therapy imat was introduced by cedric yu 1995b1. A dosimetric comparison between volumetricmodulated arc. A dosimetric comparison of volumetric modulated arc therapy. Volumetric modulation arc radiotherapy compared with static. The treatment plans ere designed to deliver a dose of 60 gy to the planning target volume t ith the same constrains in. Dosimetric comparison of rapidplan and manually optimised volumetric modulated arc therapy plans in prostate cancer loyce m. Pdf volumetric modulated arc therapy vmat is a novel radiation technique. The objective of this study was to determine if volumetric modulated arc therapy vmat offers advantages over intensity modulated radiotherapy imrt for complex brain gliomas and evaluate the rol. Volumetric modulated arc therapy vmat is a novel form of intensity modulated radiation therapy that allows the radiation dose to be delivered in a single gantry rotation using conformal or modulated fields. Volumetric modulated arc therapy vmat is an new form of imrt with continuous changeable dose rate, gantry speed, and dynamic multileaf collimator movement. Direct leaf trajectory optimization for volumetric modulated. Download citation volumetric modulated arc therapy.
To evaluate how the use of volumetricmodulated arc therapy vmat with rapidarc. Technological development, clinical application, quality. Recent advances in arc therapy imaging technology news. Purpose volumetric modulated arc therapy vmat is a specific type of intensitymodulated radiation therapy imrt in which the gantry speed, multileaf. Vmat can provide the full range of beams by gantry rotation, and change. In ten patients, fivefield imrt 5fimrt plans with fixed gantry positions were compared to ra plans using similar constraints for planning target volume ptv and oars. Whole pelvic radiation therapy wprt can reduce the rate of pelvic disease recurrence in patients who have undergone hysterectomy. Imrt in a single gantry arc otto, karl 20080101 00. Dosimetric comparison of intensity modulated and volumetric.
Dosimetric comparison of rapidplan and manually optimised. Perhaps understatedly, volumetric modulated arc therapy vmat was first introduced in 2008 as a novel radiotherapy technique where treatment is delivered efficiently and accurately using a modulated arc. The planning algorithm simultaneously changes three parameters during treatment. Commissioning of volumetric modulated arc therapy vmat core. Warrenforward2 1 british columbia cancer agency, fraser valley centre, surrey, bc, canada 2 school of health. Single arc volumetric modulated arc therapy can provide dose distributions equivalent to fixedbeam intensity modulated radiation therapy for prostatic irradiation with seminal vesicle andor lymph node involvement.
Volumetric modulated arc therapy, also known as vmat or rapid arc, delivers a precisely sculpted 3d dose distribution with a single 360degree rotation of the gantry. Plans can be generated for any current linear accelerator that supports these degrees of freedom. The m gantry is rotating continuously with the mlc leaves moving continuously while the radiation beam is on. Volumetric modulated arc therapy vmat is a rotational radiation therapy. This concept has been clinically implemented in the eclipse treatment planning software varian medical systems, palo alto, ca under the name rapidarc ra. For example, if the gantry speed is 10 degreesec and the leaf travel. The dualisocentric fourhalf arc option was utilized in volumetric modulated arc therapy vmat plans. Volumetric modulated arc therapy vmat was introduced in 2007 and was described as a novel radiation technique that has continuous modulation of mlcs field shaping, along with the dose rate and gantry speed rotation utilized to deliver highly conformal dose distributions simultaneously, in a minimal time period with reasonable mus to be. Volumetricmodulated arc therapy vs cimrt in esophageal. Dec 26, 2007 the technique is similar to tomotherapy in that a full 360 deg of beam directions are available for optimization but is fundamentally different in that the entire dose volume is delivered in a single source rotation. The dose prescription was 54 gy to the planning target volume. Single arc volumetric modulated arc therapy of head and neck cancer.
Comparing four volumetric modulated arc therapy beam. Single arc volumetric modulated arc therapy for complex brain. The capability of vmat to reduce heart and cord dose, while maintaining lung receiving 20 gy aug 30, 2014 otto k. Phys 693, sup, s673 2007 otto k 2008 volumetric modulated arc therapy. Smartarcbased volumetric modulated arc therapy can improve. Radiation oncology double arc volumetric modulated therapy improves dose distribution compared to static gantry imrt and 3d conformal radiotherapy for adjuvant therapy of gastric cancer tao zhang 0 zhiwen liang 0 jun han jianping bi zhiyong yang hong ma 0 equal contributors cancer center of union hospital, tongji medical college, huazhong university of science and technology. Imrt allows for better sparing of healthy organs and a higher dose to the tumor. Gantry speed, multileaf collimator mlc leaf position and dose rate vary.
Is a single arc sufficient in volumetricmodulated arc therapy vmat. Imrt plan and vmat plan were generated using 7 fields and 2 arcs, respectively, for the total dose of 76 gy. Imrt in a single gantry arc in this work a novel plan optimization platform is presented where treatment is delivered efficiently and. To compare variable doserate volumetric modulated arc therapy vmat with 7field, stepandshoot intensity modulated radiation therapy imrt in prostate cancer patients treated with a consistent planning target volume ptv to a uniform total radiation therapy dose. Briefly, by dynamically changing the gantry rotation speed, the shape of the multi collimator leaves, and the dose rate, ra can rapidly and efficiently achieve superior radiation.
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