title: Successful pregnancy and normal delivery after whole craniospinal irradiation in two patients.
abstract: BACKGROUND
  Two cases of normal pregnancies and deliveries after whole craniospinal irradiation (WCSI) are described, and whether the ovaries can be left out of the WCSI field by identifying ovarian position using magnetic resonance imaging (MRI) is determined.
  
  
  METHODS
  The distance between the upper edge of the pubic symphysis and the central part of the ovary was measured on MRI in 17 women.
  
  
  RESULTS
  The right ovary was located 20.3-68.4 mm to the right of and 33.7-113.5 mm above the upper edge of the pubic symphysis; the left ovary was located 26.2-72.5 mm to the left and 25.8-106.6 mm above this edge. The lower border of the spinal field in WCSI should be the caudal border of the thecal sac, i.e., S2-S4. The line of this location, which nearly approximates normal ovarian position, should be employed in radiotherapy planning to avoid irradiating at least one ovary with its thecal sac. Omitting this area from the WCSI field in women of childbearing age with a good long-term prognosis, preserves potential fertility.
  
  
  CONCLUSIONS
  It appears that the ovaries might be excluded from the WCSI field, using appropriate techniques, so as to preserve female fertility.
authors.affiliation: Department of Radiology, School of Medicine, Keio University, Tokyo, Japan. shige@rad.med.keio.ac.jp
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Shigematsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shinmoto
authors.forename: Nobutake
authors.initials: N
authors.lastname: Ito
authors.forename: Etsuo
authors.initials: E
authors.lastname: Kunieda
authors.forename: Atsuya
authors.initials: A
authors.lastname: Takeda
authors.forename: Toshio
authors.initials: T
authors.lastname: Ohashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Kawaguchi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawata
authors.forename: Hisao
authors.initials: H
authors.lastname: Ito
authors.forename: Sachio
authors.initials: S
authors.lastname: Kuribayashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kubo
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000532:radiotherapy*; D004806:Ependymoma / Q000532:radiotherapy; D005260:Female; D005298:Fertility / Q000528:radiation effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010053:Ovary / Q000502:physiology / Q000528:radiation effects*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011835:Radiation Protection / Q000379:methods*; D013120:Spinal Cord Neoplasms / Q000532:radiotherapy*