Overview

Deep inspiration breath hold (DIBH) is a technique where you hold your breath during your radiotherapy planning CT scan, and for up to 30 seconds during your radiotherapy treatment. It’s only used if the radiotherapy is going to treat lymphoma in the central chest area.

Holding your breath inflates your lungs and pushes your heart downwards within your chest. This is important as it can move your heart away from the area that we want to treat with radiotherapy. It might also mean that your lungs receive less radiation during treatment which could lead to fewer side effects.

As everyone is different due to their size, shape and internal anatomy, we’ll only know if you need to use DIBH when you have had your planning CT scans. For example, when some people breathe normally, their heart will not be in the radiation field, so they would not need DIBH.

Risks From DIBH

There are no risks associated with DIBH.

Other options

The other option to DIBH is to have radiotherapy while breathing normally. We would still try to protect your heart and lungs from the radiation, but it might be more difficult.

Preparing for DIBH

You do not need to do any specific preparation, but you might like to practise holding your breath for 20 to 30 seconds to get used to how it feels. It might feel longer than you think it might, so it’s worth trying it before you need to do it at the hospital.

During your CT scan with DIBH

Before you can have your treatment, you’ll need to have a radiotherapy planning CT scan. At your planning appointment you’ll have your first CT scan, without holding your breath.

You’ll be asked to hold your breath 3 to 4 times, and the radiographers will draw some pen marks on your skin and take some measurements. When you’re happy with the process, you’ll have another CT scan while you hold your breath. The radiographers will speak to you through an intercom and tell you when to hold your breath and when to release it.

You’ll be holding your breath for about 20 to 30 seconds. If you cannot hold your breath, we’ll give you your radiotherapy while you breathe normally.

During your radiotherapy treatment with DIBH

Each time you have your radiotherapy treatment you’ll lie down on the treatment couch in the same position as you were in for your planning CT scan.

The radiographers will move you into the correct position and will ask you to hold your breath and then release it, several times until they are happy with your position. The radiographers will then leave the treatment room and will speak to you through an intercom.

When the radiographers are ready to switch on the radiation, they’ll ask you to hold your breath. You’ll hear the treatment machine switch on. When the radiation beam is finished, they’ll tell you to release your breath. This will happen several times until the treatment is finished. The number of times that you need to hold your breath depends on how long you’re able to hold it for.

A computer monitors your breathing and position, so if you release your breath without being told to, it will alert the radiographers and they will switch the radiation off. The radiographers are watching you all the time, so if you’re not happy, you can let them know by raising your hand.

Pain

You will not feel any pain by using the DIBH technique, but it can feel a little strange to hold your breath for so long.