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We aimed to determine whether intratumoral necrosis (ITN) is a risk factor for peritumoral edema (PTE) when gamma knife radiosurgery (GKRS) is performed in patients with meningioma. In addition, we propose the concept of pseudoprogression: a temporary volume expansion that can occur after GKRS in the natural course of meningioma with ITN. This retrospective study included 127 patients who underwent GKRS for convexity meningioma between January 2019 and December 2020. Risk factors for PTE and ITN were investigated using logistic regression analysis. Analysis of variance was used to determine whether changes in tumor volume were statistically significant. After GKRS, ITN was observed in 34 (26.8%) patients, and PTE was observed in 10 (7.9%) patients. When postoperative ITN occurred after GKRS, the incidence of postoperative PTE was 18.970-fold (p\u2009=\u20090.009) greater. When a 70% dose volume\u2009\u2265\u20091\u00a0cc was used, the possibility of ITN was 5.892-fold (p\u2009&lt;\u20090.001) higher. On average, meningiomas with ITN increased in volume by 128.5% at 6\u00a0months after GKRS and then decreased to 94.6% at 12\u00a0months. When performing GKRS in meningioma, a 70% dose volume\u2009\u2265\u20091\u00a0cc is a risk factor for ITN. At 6\u00a0months after GKRS, meningiomas with ITN may experience a transient volume expansion and PTE, which are characteristics of pseudoprogression. These characteristics typically improve at 12\u00a0months following GKRS.<\/jats:p>","DOI":"10.1038\/s41598-022-17813-9","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T09:05:29Z","timestamp":1660208729000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Pseudoprogression and peritumoral edema due to intratumoral necrosis after Gamma knife radiosurgery for meningioma"],"prefix":"10.1038","volume":"12","author":[{"given":"In-Ho","family":"Jung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Won","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Hee","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Ho","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Hee","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Woo","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Seok","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,11]]},"reference":[{"key":"17813_CR1","doi-asserted-by":"publisher","first-page":"871","DOI":"10.3171\/2013.6.Jns13110","volume":"119","author":"D Ding","year":"2013","unstructured":"Ding, D., Xu, Z., McNeill, I. 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