Medical Dosimetry
Volume 32, Issue 3 , Pages 204-210, Autumn 2007

Role of Ovarian Transposition Based on the Dosimetric Effects of Craniospinal Irradiation on the Ovaries: A Case Report

Presented at the 48th Annual Meeting of the American Society of Therapeutic Radiology and Oncology; Philadelphia, PA; 2006.

  • James D. Mitchell, M.D.

      Affiliations

    • New York University School of Medicine, New York, NY
    • ,
  • Christine Hitchen, M.S.

      Affiliations

    • New York University School of Medicine, New York, NY
    • ,
  • Maria T. Vlachaki, M.D., Ph.D.

      Affiliations

    • New York University School of Medicine, New York, NY
    • Department of Radiation Oncology, Wayne State University, Detroit, MI
    • Corresponding Author InformationReprint requests to: Maria T. Vlachaki, M.D., Ph.D., Wayne State University, Department of Radiation Oncology, 540 E. Canfield, 1212 Scott Hall, Detroit, MI 48201.

Received 5 February 2007; accepted 5 February 2007.

Abstract 

In this study, we present a case of laparoscopic ovarian transposition to preserve ovarian function in an adult female patient treated with craniospinal irradiation for standard risk medulloblastoma. The prescribed dose to the craniospinal axis was 2340 cGy at 180 cGy per fraction and was delivered with 6-MV photons. Before ovarian transposition, magnetic resonance imaging (MRI) of the pelvis was obtained for localization of the ovaries and was registered with the planning computed tomography (CT) scan. Surgical clips allowed for CT localization of the ovaries after transposition. As a result of ovarian transposition, mean and maximum radiation doses decreased from 983 to 68 cGy and 1624 to 84 cGy for the left ovary and from 166 to 87 cGy and 723 to 103 cGy for the right ovary, respectively. Review of the literature indicates that such radiation doses are below the threshold that causes ovarian dysfunction and infertility. We conclude that ovarian localization with an MRI of the pelvis can be offered to females undergoing craniospinal irradiation. Transposition of the ovaries provides an option to preserve ovarian function in cases where the ovaries would otherwise be included within the radiation field.

Key Words: Medulloblastoma, Craniospinal irradiation, Ovarian transposition, Infertility

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PII: S0958-3947(07)00043-X

doi:10.1016/j.meddos.2007.02.004

Medical Dosimetry
Volume 32, Issue 3 , Pages 204-210, Autumn 2007

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