DIBH Tangent and 4 Field Filming Protocols

Deep Inspiration Breath Hold
1

Just wondering what everyone’s filming protocols are for DIBH. How often are you filming and what images are you taking?

2

Tangents (+/- Bolus) - Med & Lat MV images #1-3 then weekly

Tans + SCF - Med & Lat MV images + KV SCF #1-3 then weekly

IMRT plans with IMC - daily CBCTwith weelky multiscan (Varian TB)

Photon Boosts - Daily CBCT

Breast plans on FF protocol (5#s) Daily online CBCT

3

Imaging daily for all cases

2-field tangents MV before and during

3- field Ant KV (apply long and lateral shifts) + tangent MV (apply vertical shift only), if SCF is consistently off- CBCT is taken for dose calculation and assess if rescan +/-replan required.

4

may I ask what techniques are used for planning DIBH?

ctim in breathhold using gate CT or RPM system or simply voluntary behold like in heartspare?