Technological Development, Clinical Application, Quality Assurance and Dosimetric Validation of Volumetric Modulated Arc Therapy (VMAT): A Comprehensive Literature Review

Volumetric Modulated Arc Therapy (VMAT) is a recently developed technology which, similar to Intensity Modulated Radiotherapy (IMRT), utilizes optimization algorithms to find an acceptable solution. VMAT optimization algorithms are more complex and resource intensive than IMRT algorithms, as the former have to account for many more variables including machine-specific limitations. VMAT is distinguished from traditional fixed-beam IMRT in that radiation is delivered while the gantry rotates around the patient. It is a significant advancement over fixed gantry angle IMRT in terms of the efficiency of delivery of desired complex dose distributions (dose painting) in modern-day radiotherapy. The purpose of this review is to discuss the technological development, clinical applications and quality assurance of VMAT.