Respiratory gating for breast cancer

Optimised cardiac protection through "breath gating" during radiotherapy for left-sided breast cancer

Deep inspiration breathhold (DIBH) radiotherapy is used for patients who require post-operative radiotherapy for left-sided breast cancer.

In contrast to radiotherapy in the breath-hold position, this technique utilises the effect that the heart moves away from the chest wall during deep inspiration and greater lung filling. Radiation treatment can therefore significantly protect the heart and the coronary artery close to the chest wall. A later risk of ischaemic heart disease is thus considerably reduced.
In the Ulm area, this technique is only used at the Department of Radiotherapy and Radiation Oncology at Ulm University Hospital.

Irradiation field (blue frame) in the resting breathing position and during deep inspiration. The distance between the heart and the chest wall increases (arrows).

Both the radiotherapy planning and the subsequent radiotherapy are carried out on a comfortable couch with arms stretched upwards. Using special glasses, the patient can look at a monitor on which her own breathing curve is graphically displayed. In addition, an area is shown on the graph that represents the optimum inhalation. These optical aids guarantee that the same deep breath is always taken during CT-based planning and subsequent radiotherapy.