This leaflet answers common questions about the deep inspiration breath hold (DIBH) technique used with radiotherapy. It should be read in conjunction with an information leaflet for the part of the body you are having treated.  

If you would like further information, or have any worries, please do not hesitate to ask your radiotherapy radiographer or radiotherapy review specialist. 

A radiotherapy radiographer will explain the procedure to you and answer any questions you may have. 

In most cases it will be possible for a friend or relative to accompany you for all or part of the procedure. This will depend on any infection control guidelines currently in place. Please ask your radiographer or doctor.  

What is DIBH?

Deep inspiration breath hold is a technique used for holding your breath during your planning computerised tomography (CT) scan and while receiving radiotherapy treatment. 

Why is it necessary?

Holding your breath stops your chest moving and helps to keep you still – this makes it easier to focus radiotherapy to the specific area needing treatment. 

Your breast and chest wall along with some of the lymph nodes in your chest (IMC nodes) are also very close to your heart. In some patients, this makes it difficult to deliver radiotherapy treatment without the heart receiving a small amount of the radiation dose as well. Holding your breath causes your lungs to expand (inflate) and this pushes the area being treated away from your heart, minimising the dose it might receive. 

Before your procedure

Prior to attending for your CT scan or first treatment, it is beneficial to have practiced the DIBH technique at home.  

You can find videos and more information on this technique on the respire website: www.respire.org.uk. 

The respire website contains a series of resources developed from a partnership between healthcare professionals and patient representatives. Designed for patients who have been referred for radiotherapy to the breast or chest wall. In particular, the aim of the resources is to help you to learn how to hold your breath for a short time during your radiotherapy. 

You can also access the website using this QR code:  

 

You can practise the DIBH technique by following these steps: 

  1. Lie flat on your back with your arms comfortably raised above your head.  
  2. Take slow steady breaths in through your nose and out through your mouth. 
  3. Once you are comfortable breathing in this way, take a deep breath in through your nose and hold it for approximately 10 seconds. Take special care that no breath escapes in this time as it is important that your breath holds are consistent. After the time has elapsed, breath out through your mouth.  
  4. Gradually increase the length of time you hold your breath in five second increments until you reach 25-30 seconds of being able to hold your breath comfortably.  
  5. Do not practice more than three or four breaths per session.  

The DIBH technique

DIBH is done by placing the RPM block (a small plastic block) on your chest. You will be guided by the radiographers who will coach you on how to hold your breath. The CT planning scan and radiotherapy treatment will begin when you are comfortable with this technique. 

Performing the DIBH technique

You will need to be able to take a deep breath in and hold it for at least 25 seconds to be able to use this technique. The radiographers will practice this with you at your planning appointment to make sure you are comfortable and confident before going ahead with the scan. 

During your planning scan and treatment sessions you will need to hold your breath like this on several successive occasions. 

Not everyone will be able to perform DIBH, and this technique may not be suitable for all patients. 

If you are unable to hold your breath for your treatment there are alternative methods available to be able to minimise the exposure to your heart.  You can discuss this with a member of the radiotherapy team. 

You may decide that you do not wish to have to hold your breath during your treatment. This is an option you can choose, and you will be able to discuss this with the radiotherapy team.