A cost-effective technique for cardiac sparing with deep inspiration-breath hold (DIBH)

Bryan D. Macrie, Eric D. Donnelly, John P. Hayes, Mahesh Gopalakrishnan, Rino T. Philip, Jozef Reczek, Adam Prescott, Jonathan B. Strauss*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Deep inspiration breath hold (DIBH) is an effective technique to reduce cardiac and pulmonary dose during breast radiotherapy (RT). However, as a result of expense and the technical challenges of program implementation, DIBH has not been widely adopted in clinical practice.This report describes a program for DIBH this is relatively inexpensive to implement and has little impact on patient throughput. Multiple redundant mechanisms are incorporated to assure accurate and safe delivery of RT during DIBH. Laser alignment verifies that chest wall excursion is reliably reproduced and maintained during treatment. Chest wall excursion is also monitored independently using an infrared camera trained on a reflective marker on the chest wall. This system automatically triggers "beam off" in the event of movement of the target beyond pre-determined thresholds. Finally, physician review of cine imaging obtained during treatment provides an off-line verification of accurate RT delivery. The approach described herein lowers the investment necessary for implementation of DIBH and may facilitate broader adoption of this valuable technique.

Original languageEnglish (US)
Pages (from-to)733-737
Number of pages5
JournalPhysica Medica
Issue number7
StatePublished - Nov 2015


  • Breast cancer
  • Cardiac sparing
  • DIBH
  • Deep inspiratory breath hold
  • IGRT
  • Radiotherapy

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging
  • Physics and Astronomy(all)


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