{"entity":{"id":"deep-inspiration-breath-hold","kind":"term","name":"Deep inspiration breath-hold (DIBH)","aka":[],"tldr":"Taking and holding a deep breath during each radiation beam. For left-sided breast cancer it pulls the heart away from the chest wall and cuts heart dose by about half.","summary":"In breath-hold the lungs inflate, the diaphragm drops and the heart moves down and back, away from the breast and chest wall being treated. The beam is only on while surface tracking or a spirometer confirms the patient is at the right breath-hold level. DIBH is now standard for most left breast and many lymphoma and lung treatments, and is one of the main reasons modern breast radiotherapy carries far less long-term heart risk than it did in the 1990s.","asOf":"2026-09-17","wikipedia":"https://en.wikipedia.org/wiki/Respiratory_gating","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Respiratory_gating"},{"label":"Major coronary events rise 7.4 percent per gray of mean heart dose (New England Journal of Medicine 2013)","url":"https://doi.org/10.1056/NEJMoa1209825"}],"tags":["radiation-wave1","precision"],"related":["post-mastectomy-radiotherapy"],"cancers":["breast-hr-positive","breast-her2-positive","tnbc","hodgkin-lymphoma","breast-cancer"],"sections":[],"technologies":["respiratory-motion-management","surface-guided-radiotherapy"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-heartspare-stage-ii-clin-oncol-2017","paper-smyth-dibh-cardiac-sparing-review-jmrs-2015"],"journals":[],"dependsOn":[],"notes":[],"category":"Procedures"},"route":"/terms/deep-inspiration-breath-hold/","neighbours":{"term":[{"id":"rejuv-second-choices-made-at-treatment","kind":"term","name":"Choices made at the time of treatment that change the second cancer risk","route":"/terms/rejuv-second-choices-made-at-treatment/"},{"id":"post-mastectomy-radiotherapy","kind":"term","name":"Radiotherapy after mastectomy","route":"/terms/post-mastectomy-radiotherapy/"},{"id":"rejuv-second-radiotherapy-dose-field-and-age","kind":"term","name":"Radiotherapy and second cancers: field, dose and age at exposure","route":"/terms/rejuv-second-radiotherapy-dose-field-and-age/"}],"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"hodgkin-lymphoma","kind":"cancer","name":"Hodgkin lymphoma","route":"/cancers/hodgkin-lymphoma/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"respiratory-motion-management","kind":"technology","name":"Respiratory motion management (4D-CT, gating, breath-hold, tracking)","route":"/technologies/respiratory-motion-management/"},{"id":"surface-guided-radiotherapy","kind":"technology","name":"Surface-guided radiotherapy (SGRT)","route":"/technologies/surface-guided-radiotherapy/"}],"paper":[{"id":"paper-smyth-dibh-cardiac-sparing-review-jmrs-2015","kind":"paper","name":"The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review","route":"/key-papers/paper-smyth-dibh-cardiac-sparing-review-jmrs-2015/"},{"id":"paper-heartspare-stage-ii-clin-oncol-2017","kind":"paper","name":"The UK HeartSpare Study (Stage II): multicentre evaluation of a voluntary breath-hold technique in patients receiving breast radiotherapy","route":"/key-papers/paper-heartspare-stage-ii-clin-oncol-2017/"}],"roadmap":[{"id":"precision-roadmap","kind":"roadmap","name":"Precision roadmap: margins measured in millimetres → tests that find a target → doses fitted to the person → precision that changes outcomes","route":"/roadmaps/precision-roadmap/"}],"idea":[{"id":"idea-pu-breath-hold-coaching-before-planning","kind":"idea","name":"Breath-hold coaching and home practice a week before the planning scan, in the patient's own language","route":"/ideas/idea-pu-breath-hold-coaching-before-planning/"},{"id":"idea-pu-breath-hold-left-breast-routine","kind":"idea","name":"Deep-breath-hold radiotherapy for every suitable person with left-sided breast cancer","route":"/ideas/idea-pu-breath-hold-left-breast-routine/"},{"id":"idea-pu-breath-hold-visual-feedback","kind":"idea","name":"Let the patient see their own breath-hold on a screen or in video glasses","route":"/ideas/idea-pu-breath-hold-visual-feedback/"}]}}