A deep breath in can spare the heart from radiation

With a technique known as Deep Inspiration Breath Hold (DIBH), patients with breast cancer undergoing radiation therapy can limit radiation exposure to their hearts, according to results from a recent analysis published in the Journal of Medical Radiation Sciences.

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Preventing myocardial damagefrom radiation

DIBH uses breathing patterns to limit radiation exposure to the heart.

Preventing myocardial damagefrom radiation

DIBH uses breathing patterns to limit radiation exposure to the heart.

Even low doses of radiation during treatment for breast cancer—especially in women who receive radiation to the left breast—can damage myocardial tissue. DIBH, which uses a woman’s breathing patterns to limit radiation exposure to the heart, can cut the average dose of radiation to the heart by 26.2% to 75%, according to these results.

“As you take a deep breath in, your lung expands, moving the breast up away from the heart while also pushing the heart backwards away from the chest wall and the treatment field,” explains Chad DeYoung, MD, co-director, Radiation Oncology, Valley-Mount Sinai Comprehensive Cancer Care, New York City/Ridgewood, NJ. “This can displace the heart by as much as a couple of centimeters, which might sound like a small shift, but can actually make a big difference in sparing the heart from receiving direct radiation.”

Real-time monitoring is used to ensure that the radiation therapy is delivered at the optimal time, with sensors on the patient’s chest monitoring chest displacement as a deep breath is taken. This allows the radiologist to deliver the treatment accurately at precisely the right time, when radiation to the heart is at its lowest, using a TrueBeam linear accelerator. The radiation treatment will not be delivered if there is too much or too little air in the patient’s lungs.

“The DIBH procedure enables us to provide appropriate breast cancer patients with highly targeted radiation treatments. This is crucial because it protects the patient’s heart by ensuring that it receives minimal radiation during treatment,” added Michael Wesson, MD, co-director of radiation oncology, Valley-Mount Sinai Comprehensive Cancer Care.