Deep Inspiration Breath Hold (DIBH)

Patients whose tumour position changes due to respiratory movements are irradiated using a controlled breathing method called Deep Inspiration Breath Hold (DIBH). Here you will learn what the Dyn’R is, how the breathing method works, and what awaits patients during the Dyn’R training.

What is the Dyn’R?
Dyn’R is the name of the special spirometer that serves not only to monitor breathing, as the conventional spirometer does, but also allows the irradiation beam to function only when the breath is held at a certain level. This irradiation technique is called Deep Inspiration Breath Hold (DIBH).

Why do patients get irradiated with the Dyn’R?
This method has been chosen for a clear reason – it is important that the irradiated area of the body and the target volume of the tumour are irradiated the same way during each fraction. Since this irradiated volume varies depending on breathing, we need to ensure that the patient´s body is always in the same position. This is best done by holding their breath at a certain level. To determine this level, the patient first undergoes a controlled breathing training (Dyn’R training).

Controlled Breathing Training

The controlled breathing training is done lying down on the back after being connected to the spirometer, using an antibacterial filter and a mouthpiece. The patient´s nose is held closed by a pin so that all exhaled air flows through their mouth. The patient also wears special glasses, where they see the breathing pattern to follow. The training is conducted by an experienced assistant.

During each irradiation, the patient lies on the radiation table the same way they did during the training, and breathes with the DIBH technique. The radiation application itself is painless and the patient does not feel the radiation. If the patient accidentally does not manage to hold their breath for the required 20 seconds, they do not have to worry. If they breathe out, the device will detect it and stop irradiation automatically.