Can someone explain the steps in DIBH?

[thesauce]

I wanted to see if someone here could please explain the steps in deep inspiratory breath hold (DIBH) for breast cancer.

Specifically: How is the sim different? What instructions do you give to the patient? How do you do the treatment itself? What kind of things make the patient a good candidate or a poor candidate?

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[PruritisAni]

I wanted to see if someone here could please explain the steps in deep inspiratory breath hold (DIBH) for breast cancer.

Specifically: How is the sim different? What instructions do you give to the patient? How do you do the treatment itself? What kind of things make the patient a good candidate or a poor candidate?

Take a deep breath and hold it. That's it.

Need to get the software/hardware for respiratory monitoring and some mechanism for visual feedback (video goggles) so an inspiratory goal/target can be set (at a comfortable level for the patient). The patient then used this feedback to inspire into the goal range, hold breath at that level. Obtain sim images at that inspiration volume, plan on it. Then patient gets that same feedback for the actual treatments.

Technique pulls heart away and down/elongated from the chest wall.

 

[PruritisAni]

Good candidate - athletes (can hold breath)

Poor candidates - copd, chf, etc. need to have capacity to hold breath for many seconds.

 

[Brim]