How do you assess whether a patient will be a good DIBH candidate for lung or abdomen treatments?

Assessments are made at the time of simulation. Every patient has a motion assessment performed to determine the degree of motion management required. Typically, if a patient has >1 cm of motion, we will determine if DIBH is appropriate.

Patients undergo a coaching protocol using audio/visual feedback. If they are unable to perform coached breathing techniques, we will pivot to another method such as respiratory gating.

Our clinic doesn't have other standard factors that we assess.

It has taken me some time to accept DIBH and tend to lean towards EEBH only because I have seen more difficulty with reproducibility with DIBH. There are definitely situations where DIBH may be beneficial (i.e, pushing a primary away from the heart), but at least for me, I am still a bit hesitant doing it and prefer EEBH when too much motion (> 1 cm).