Breast And Deep Inspiration Breath Hold (DIBH)

Radiation therapy has been shown to be a highly effective treatment for breast cancer. But the proximity of the left breast to the heart leaves the heart vulnerable to radiation exposure. This has been shown, in some cases, to lead to serious long-term cardiac complications¹.

Many centers are beginning to have patients use Deep Inspiration Breath Hold (DIBH) to move the heart away from the breast during therapy. However, achieving this can be challenging². Patients breathe in different ways at different times and may arch their back to simulate a deep breath in. These different movements can appear similar to a patient’s true breath-hold, but do not necessarily separate the heart from the breast.

TRaditional versus AlignRT and DIBH
Breast and Deep Inspiration Breath Hold (DIBH)

During a recent study at the University of North Carolina, patients were treated using AlignRT for DIBH. Of these, 0% exhibited radiation-induced abnormalities in blood flow to the heart six months after treatment³.

There are 10 published papers covering the use of AlignRT for DIBH, and accessories are available to make DIBH with AlignRT even simpler for the patient and therapist.

Learn more about our RealTime Coach display, to simplify patients’ breath-hold here. 

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Education - Publications

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Access clinical papers and publications about AlignRT for breast and DIBH.

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1. Darby et al. Risk of Ischemic Heart Disease in Women after Radiotherapy for Breast Cancer. N Engl J Med 2013; 368:987-998

2. Gierga et al. A Voluntary Breath-Hold Treatment Technique for the Left Breast With Unfavorable Cardiac Anatomy Using Surface Imaging. Int J Radiat Oncol Biol Phys. 2012 Dec 1;84(5):e663-8

3. Zagar et al. Prospective Assessment of Deep Inspiration Breath Hold to Prevent Radiation Associated Cardiac Perfusion Defects in Patients With Left-Sided Breast Cancer J Appl Clin Med Phys. 2015 ;93:3S 2027

4. Marks, L. B. et al. The incidence and functional consequences of RT‑associated cardiac perfusion defects. Int. J. Radiat. Oncol. Biol. Phys. 63, 214–223 (2005)

*This customer quote reports on clinical use and performance of Vision RT’s products by independent users. These are not validated by Vision RT and thus are not endorsed by Vision RT. Users of Vision RT’s products should develop and validate their own workflows consistent with clinical practice within their facility.

Testimonials

  • "Vision RT decreases both the time of breast setup for right and left breast lesions, and has really improved our accuracy. Vision RT has also improved the setup for many other disease sites … it is improving our accuracy and throughput."  
    Nancy Wiggers MD - Nancy Wiggers MD - Radiation Oncologist, Department Chair, Northside Hospital*
  • “What we were really after was equivalent positional accuracy. If we could find a technology and justify to ourselves that it is equivalent to existing technologies, that’s what we were going for. Enter Vision RT and their AlignRT product, and we had the tool that we were looking for.”
    Todd Pawlicki, PhD DABR FAAPM - Todd Pawlicki, PhD DABR FAAPM - Vice Chair and Professor, Dept. of Radiation Medicine and Applied Sciences, UCSD
  • “Vision RT provides a simple-to-use and very effective way to save dose to the heart and lung in these patients. Our ambition is to widen the use of respiratory gating in the future.”
    Mathias Dierl - Mathias Dierl - Head of Medical Physics, Klinikum Bayreuth, Germany
  • "It is much easier to prepare and edit the patient data in AlignRT Advance. The best feature is the Postural Video module because it allows fast recognition of misalignments. It is a powerful tool to understand exactly where the changes happen when the patient falls outside tolerance during the treatment."
    Dr. Vania Batista -Dr. Vania Batista -Heidelberg University Hospital
  • “AlignRT is a safe and non-invasive method to accurately position and monitor patients throughout treatment delivery.”
    Karl Jordan - Karl Jordan - Medical Physicist. St Vincent's Private Hospital (SVPH) Dublin
  • “We’ve had 53 out of 54 patients where we have not had to repeat their weekly X-Ray images. That is a significant finding for us –it’s showing us that we’re getting a dose reduction because we’re not having to repeat X-Ray images on these patients, and it’s also showing us how reliable the AlignRT system really is in patient positioning.”
    Heather Warmouth BS RT(T) - Heather Warmouth BS RT(T) - Radiation Therapist, Fletcher Allen Health Care (TX):
  • "I have to say that this is really the missing piece that we felt we needed in order to move fully to frameless, image-guided radiation … we are very comfortable treating multiple metastases, feeling that we are able to give treatment as planned."  
    Josh Yamada MD FRCPC - Josh Yamada MD FRCPC - Memorial Sloan Kettering Cancer Center*
  • “AlignRT helps us increase confidence in every treatment we use it for allowing for more accurate treatment delivery. In addition, tattooless treatments are proving popular with our patients.”
    Luke Rock - Luke Rock - Head of Medical Physics, Beacon Hospital, Dublin
  • "With SBRT, since it is such a high dose in such a small amount of time we often [used to] reimage in the middle of treatment, and AlignRT® has helped us not have to do that … [it’s] a huge time-saver."  ............ ............ ..................    ........     .......  
    Kristen Beck - Kristen Beck - Staff Radiation Physicist, Sutter Medical Foundation

*These customer quotes report on clinical use and performance of Vision RT’s products by independent users. These are not validated by Vision RT and thus are not endorsed by Vision RT. Users of Vision RT’s products should develop and validate their own workflows consistent with clinical practice within their facility.