One of the concerns for both men and women facing treatment for cancer is how the therapy will affect their future fertility. Thus, couples planning parenthood often seek available options to protect them from becoming infertile afterwards.
One of those anti-cancer treatments is radiation therapy. Exposing the reproductive areas of the body to such radiation may cause infertility. Direct radiation to areas like the prostate gland, testicles, ovaries and uterus has the potential to result in permanent sterility.1
Risks of High-Resolution Scanning
Similar to radiation therapy, a form of diagnostic imaging known as multidetector computed tomography, or MDCT, scanning can potentially expose the testes to direct radiation. But doctors in a new study published this month point to a unique lead capsule that may provide protection during these types of scans.2
An MDCT scan is a form of computed tomography (CT) technology for diagnostic imaging. It provides doctors the ability to view parts of the body at a much higher resolution than normal CT scanning. "MDCT is a general diagnosis tool using x-rays," explained Christian Hohl, MD, of the University of Technology of Aachen in Germany and this study's chief investigator, in an interview with Priority Healthcare. "MDCT is used to answer nearly all diagnostic questions regarding imaging, especially tumor staging and follow-up."
But while MDCT greatly offers improved image quality and resolution, the risk of radiation exposure also dramatically increases, Hohl said. In addition to potential infertility, radiation damage to the testes could also lead to cancer or sperm mutation, according to the researchers. And so far, there haven't been simple solutions. "There are several attempts to cope with the increasing dose of MDCT," explained Hohl, in the department of Diagnostic Radiology at the university. "But most of them are complex and expensive."
That's why he and his fellow investigators wanted to find out if the old-fashioned lead capsule might be effective.
A Well-Known Intervention
The capsule evaluated in this study was previously used only in X-ray imaging. Hohl's research team wanted to determine if it could protect the male testicles during abdominal and pelvic MDCT scanning just as effectively. "Shielding the gonads has been a routine dose-reduction method during X-ray exposure in conventional radiography for many years," write the study researchers. "The aim of this study was to prove that the 'old-fashioned' gonad shield is an inexpensive and easy-to-use method to protect the male gonads during MDCT," Hohl said.
"We asked ourselves why we were attaching the gonad shield in every routine x-ray [at our hospital] with relatively low radiation exposure, but never put this device on in high-dose examinations such as abdominopelvic-MDCT," Hohl told Priority Healthcare. Prior to this study, MDCT scanning at Hohl's medical institution was offered without any protection for the testes, he said.
"For their research, Hohl and his colleagues analyzed a group of 66 men who underwent routine MDCT of the abdomen and pelvis. About half of the participants used the lead capsule during the scans, and rest did not. The capsule is shaped like a small plastic-type cup that is placed over the testicles.
Hohl's team learned that radiation exposure to the testicles was reduced by as much as 87% in the group of men who wore the capsule compared to those who did not.
New Discovery
To the best of their knowledge, Hohl's group says no other studies have evaluated the efficacy of using a lead capsule to protect the testes during MDCT scanning. Most other devices, such as a lead apron to protect the ovaries, a special wrap-around device used for testicular protection, and a thyroid collar used to protect the thyroid gland, were used in conjunction with more standard CT scanning, Hohl and his team wrote.
With CT scanning becoming more complex and more widely used around the world, the need to shield certain parts of the body to intense radiation exposure is becoming increasingly necessary, Hohl said.
"In conclusion, the capsules that we used as gonadal shields are commercially available, easy to use, and well accepted by patients," wrote Hohl and his colleagues.
"We were greeted with smiles for using this 'oldie' in a state-of-the-art MDCT scanner," Hohl said.
1. Fertile Hope. Fertility Risks: Radiation. Available at: http://www.fertilehope.org/resources/risks.cfm. Accessed January 25, 2005.
2. Hohl C, Mahnken AH, Klotz E et al. Radiation dose reduction to the male gonads during MDCT: the effectiveness of a lead shield. AJR Am J Roentgenol 2005 Jan;184(1):128-30.
John Martin is a long-time health journalist and an editor for Priority Healthcare. His credits include coverage of health news for the website of Fox Television's The Health Network, and articles for the New York Post and other consumer and trade publications.
