Breast Clinical Session: DIBH

Dr Santam Chakraborty

What is DIBH

A form of gating where you rely on patients ability to hold the respiration for the “gate”.

Called a deep inspiration as we ask the patient to breath in deeply and hold it there.

What are the methods available

  • RPM based systems

  • ABC based systems

  • Laser based systems

  • Surface guidance systems

Cardiac sparing

Why do DIBH

  • Sparing heart

  • Sparing substructures of the heart.

Cardiac Doses: Do they Matter

RPM based DIBH Implementation

Patient selection

  • Patients should be able to hold breath for about 20 sec

  • We do not select based on FB threshold

  • Practically all left breast cancers

  • Pretreatment counselling

    • Physician

    • Radiographers

  • Practice sessions

  • Final Scan

RPM based DIBH

Image courtesy Ms Anurupa Mahata

RPM based DIBH

Image courtesy Ms Anurupa Mahata