Medicine

Patient information for Translation

Deep Inspiration Breath Hold Technique for Radiotherapy (DIBH)

Important: Please tell us if you have a pacemaker as we will need to monitor your heart during your treatment.

Please let us know if you are pregnant or think you might be pregnant.

It is important to remember that you need to use contraception whilst receiving treatment for cancer in order to prevent pregnancy – please see our leaflet ‘Avoiding pregnancy during radiotherapy and chemotherapy’

Who is this leaflet for?

This leaflet is for patients having radiotherapy to the breast or chest wall using Deep Inspiration Breath Hold technique (DIBH).   

What is the Deep Inspiration Breath Hold technique?

Deep Inspiration Breath Hold is an effective method of limiting radiation exposure to the heart.

This treatment technique requires you to hold your breath in intervals (for around 20 seconds) during your planning CT scan and radiotherapy treatment. By holding your breath, and inflating your lungs, the heart is pushed away from the treatment area. It also stops any movement caused by breathing.

This treatment technique will be discussed with you by your oncologist. The oncologist will take into account your ability to comfortably hold your breath for a short period of time. 

What will you need to do?

At home, practice holding your breath for 20 seconds. Repeat this several times in a row.  Daily practice will help improve your ability and confidence in achieving breath hold comfortably. 

At the CT scan, the radiographers will explain and demonstrate what a ‘deep inspiration’ breath means. The radiographers will practice this with you to make sure you are comfortable before going ahead with the scan.

When you inhale, it is important that you inflate your lungs rather than arch your back and lift your shoulders. You do not need to over inflate your lungs for this technique to work. It is more effective if you inflate your lungs so they are comfortably full rather than try to breathe in too much. The breath needs to be easy to replicate and hold for around 20 seconds.

Tips to performing DIBH.

• Relax.
• Follow the visual and audio prompts.
• Breathe in through your nose (if you can).
• Lie heavy on the bed and focus on expanding your lungs.
• Don’t arch your back when you breathe in.  
• Don’t raise your shoulders when you breathe in.

What to expect at the planning CT scan appointment?

You will have a CT scan to plan your treatment. This will help the oncologist plan the size and shape of the x-ray beams needed to accurately treat you.

The radiographers will position you on the couch. A small plastic box will be placed on your chest and a camera will monitor the motion of this box. This motion represents your breathing.

A mirror will be placed above you. The mirror will display a reflection of your breathing pattern. Ask the radiographers to adjust the mirror if you cannot see clearly.

The display will help you to see if you are taking enough air into your lungs. Your breathing is represented by a white line and the target area is a green box. The radiographers will ask you to breathe in a hold the white line into the green target box for approximately 20 seconds.

It is important to take a consistent deep breath. If you are finding it difficult to breathe in and hold, please inform the CT radiographers. The settings are individual and can be adjusted.

If you are unable to achieve and maintain ‘breath hold’ successfully, please do not worry. With advanced planning techniques we are also able to limit the dose your heart may receive without asking you to hold your breath.

What to expect during the treatment appointments?

The radiographers will position you on the couch in exactly the same way as you were for the CT scan. A small plastic box will be placed on your chest and a camera will monitor the motion of this box. The mirror will then be positioned.

The radiographers will practice the breathing with you to make sure you are comfortable and able to consistently breathe into the blue target box. You will be given verbal instructions through an intercom system. Ask the radiographers to adjust the volume if you cannot hear.

When you are in the correct position the radiographers will leave the room. Lie still and breathe normally. You will be monitored on CCTV. 

The radiographers will speak to you through the intercom system to let you know when to breathe in. Don’t rush – when you feel ready, take a deep breath in and hold it.

Once you are in the breath hold position, the treatment machine will deliver the radiation treatment. When this section of the treatment is completed, the treatment machine will switch off and the radiographer will tell you to breathe normally. This process will then be repeated until your treatment is completed. 

Important!

Relax and follow the visual and audio prompts.  Please remember: 

• If your breath does not reach the target area, the treatment machine will not turn on. 
• If you release your breath without being told to, the treatment machine will switch off. 

The radiographers will be monitoring you the whole time and will help to guide you through the treatment.

Contact Us

Radiotherapy

King George V Wing (KGV), Basement level, St Bartholomew’s Hospital, West Smithfield, London EC1A 7BE

Radiotherapy Reception 020 3465 5222

Emergency Hotline (when the department is closed) 07917 093 738

Macmillan Cancer Information Centre

Vicky Clement-Jones

West Wing Ground Floor, St Bartholomew’s Hospital

Mon–Fri:10am-12noon 2-4.30pm

Tel:020 346 56611

Maggie’s Centre @ St Barts

St Bartholomew’s Hospital, West Smithfield, London, EC1A 7BE

Tel: 0203 904 3448

Drop in Mon-Fri: 9am-4pm

https://www.maggiescentres.org/our-centres/maggies-barts/

Support websites and groups.

Cancer Research UK

www.cancerhelp.org.uk  020 7061 8355

Large print and other languages
This information can be made available in alternative formats, such as easy read or large print, and may be available in alternative languages, upon request. For more information, speak to your clinical team.
 

এই তথ্যগুলো সহজে পড়া যায় অথবা বৃহৎ প্রিন্টের মত বিকল্প ফরম্যাটে পাওয়া যাবে, এবং অনুরোধে অন্য ভাষায়ও পাওয়া যেতে পারে। আরো তথ্যের জন্য আপনার ক্লিনিক্যাল টিমের সাথে কথা বলুন।

Na żądanie te informacje mogą zostać udostępnione w innych formatach, takich jak zapis większą czcionką lub łatwą do czytania, a także w innych językach. Aby uzyskać więcej informacji, porozmawiaj ze swoim zespołem specjalistów.

Macluumaadkaan waxaa loo heli karaa qaab kale, sida ugu akhrinta ugu fudud, ama far waa weyn, waxana laga yabaa in lagu heli luuqaado Kale, haddii la codsado. Wixii macluumaad dheeraad ah, kala hadal kooxda xarunta caafimaadka.

Bu bilgi, kolay okunurluk veya büyük baskılar gibi alternatif biçimlerde sunulabilir, ve talep üzerine Alternatif Dillerde sunulabilir. Daha fazla bilgi için klinik ekibinizle irtibata geçin.

یہ معلومات متبادل فارمیٹس میں دستیاب کی جا سکتی ہیں، جیسا کہ پڑھنے میں آسان یا بڑا پرنٹ  اور درخواست پر متبادل زبانوں میں بھی دستیاب ہو سکتی ہیں۔ مزید معلومات کے لیے، اپنی کلینکل ٹیم سے بات کریں'۔

Patient Advice and Liaison Service (PALS)

Please contact us if you need general information or advice about Trust services: www.bartshealth.nhs.uk/pals

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Reference: BH/PIN/856

Publication date: Jan 2022

All our patient information leaflets are reviewed every three years.

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