World silver medalist Reiko Tosa twisted her left ankle and may be unable to take part in the Tokyo International Women's Marathon this fall, marathon sources said Wednesday.

The 27-year-old is unsure whether she can run in the Nov. 16 race which doubles as an Olympic qualifier after injuring herself in China, where she had been training earlier this month.

She is currently back in Japan to receive treatment, the sources said. Tosa won the silver medal in the 2001 World Championships in Edmonton, Alberta.

In December 2002, she was diagnosed with a fracture to her right ankle and in April made her comeback after being away from action for over seven months.