Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2015;11(1):5-10.
Published online June 30, 2015.
Post-Radiosurgical Peritumoral Change in Meningioma Treated with Gamma Knife?? Radiosurgery
Seung Hwan Kim, Sun-il Lee, Seong Jin Jin, Jung Soo Kim, Hae Yu Kim
1Gamma Knife Center, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Department of Neurosurgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
Abstract
Objective
This study was focused on postradiosurgical peritumoral edema (PTE) occurrence and its related factors after Gamma knife radiosurgery (GKRS) for benign intracranial meningiomas. Furthermore we would like to suggest the points we should consider to avoid PTE after GKRS.
Methods
We retrospectively reviewed clinical and imaging data collected in our institute. Data from 98 patients with 109 meningiomas were analyzed. The mean age was 57.25±11.91, and the median follow-up period was 13 months (range : 8–35). Several risk factors such as age, sex, preoperative PTE, target volume (TV), tumor location, tumor-brain contact interface area (TBCI), prescription isodose volume (PIV), prescription maximal dose (PMD), gradient index (GI), and conformality index (CI) were investigated.
Results
Of the 109 tumors in 98 patients, postradiosurgical peritumoral edema was observed in 37 tumors (33.9%) in 12 patients (12.2%). Compared with tumors without preradiosurgical peritumoral edema, the odds of developing postradiosurgical peritumoral with preradiosurgical peritumoral edema were 8.16 times higher (p<0.001). Tumor-brain contact interface area (p=0.001), prescription isodose volume (p=0.032), and conformality index (p=0.034) were statistically significant risk factors for postradiosurgical PTE.
Conclusions
Postradiosurgical peritumoral edema is the most common adverse event in meningioma patients treated with GKRS. Preradiosurgical PTE and TBCI should be considered when considering GKRS as a treatment modality, and prescription isodose volume and conformality index should be considered during GKRS planning.
Key Words: Radiosurgery, Meningioma, Peritumoral edema, Gradient index, Conformality index.


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