{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T22:15:07Z","timestamp":1791756907683,"version":"4.3.4"},"reference-count":52,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:p>Symptomatic edema is a potential complication of meningioma radiosurgery. Parasagittal meningiomas are at a particular risk for symptomatic edema, suggesting a role for a venous occlusive complication. The authors sought to develop a strategy to optimize CyberKnife stereotactic radiosurgical treatment parameters to reduce the irradiation of the peritumoral venous system. Multislice CT venography with 3D reconstructions was performed and coregistered with thin-section, contrast-enhanced, volumetric MR images. The tumor and critical volumes were contoured on the MR images. Venous anatomical details obtained from the CT venographic study were then exported onto the MR imaging and fused MR imaging-CT study. Target and critical structure volumes and dosimetric parameters obtained with this method were analyzed. The authors found that reducing the irradiation of veins that course along the surface of the meningioma, which may be at risk for radiation-induced occlusion, is feasible in parasagittal meningioma radiosurgery without compromising other treatment parameters including conformality, homogeneity, and target coverage. Long-term follow-up is needed to assess the clinical validity of this treatment strategy.<\/jats:p>","DOI":"10.3171\/2009.8.focus09-157","type":"journal-article","created":{"date-parts":[[2009,10,30]],"date-time":"2009-10-30T10:00:32Z","timestamp":1256896832000},"page":"E11","source":"Crossref","is-referenced-by-count":32,"title":["Protecting venous structures during radiosurgery for parasagittal meningiomas"],"prefix":"10.3171","volume":"27","author":[{"given":"Alfredo","family":"Conti","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Pontoriero","sequence":"additional","affiliation":[{"name":"Radiation Oncology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignazio","family":"Salamone","sequence":"additional","affiliation":[{"name":"Radiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Siragusa","sequence":"additional","affiliation":[{"name":"Medical Physics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Midili","sequence":"additional","affiliation":[{"name":"Medical Physics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"La Torre","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amedeo","family":"Calisto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS Ospedale Pediatrico Bambino Ges\u00f9, Rome; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Granata","sequence":"additional","affiliation":[{"name":"Neuroradiology, University of Messina, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pantaleo","family":"Romanelli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costantino","family":"De Renzis","sequence":"additional","affiliation":[{"name":"Radiation Oncology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Tomasello","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0270011","series-title":"Neurosurgery","first-page":"1229","article-title":"Stereotactic radiosurgery for cavernous malformations: Kjellberg's experience with proton beam therapy in 98 cases at the Harvard cyclotron","volume":"42","author":"Amin-Hanjani","year":"1998"},{"key":"b2-0270011","series-title":"J Neurol Neurosurg Psychiatry","first-page":"226","article-title":"Complications after gamma knife radiosurgery for benign meningiomas","volume":"74","author":"Chang","year":"2003"},{"key":"b3-0270011","series-title":"Radiat Oncol","first-page":"46","article-title":"CyberKnife radiosurgery in the treatment of complex skull base tumors: analysis of treatment planning parameters","volume":"1","author":"Collins","year":"2006"},{"key":"b4-0270011","series-title":"Neurosurgery","first-page":"1263","article-title":"Meningiomas invading the superior sagittal sinus: surgical experience in 108 cases","volume":"55","author":"DiMeco","year":"2004"},{"key":"b5-0270011","series-title":"Acta Neurochir Suppl (Wien)","first-page":"92","article-title":"Radiosurgery for vascular malformations of the brain stem","volume":"58","author":"Duma","year":"1993"},{"issue":"1 Suppl","key":"b6-0270011","series-title":"Stereotact Funct Neurosurg","first-page":"129","article-title":"Radiation-induced edema after Gamma Knife treatment for meningiomas","volume":"66","author":"Ganz","year":"1996"},{"issue":"5 Suppl","key":"b7-0270011","series-title":"Neurosurgery","first-page":"A19","article-title":"Comparison of early complications for patients with convexity and parasagittal meningiomas treated with either stereotactic radiosurgery or fractionated stereotactic radiotherapy","volume":"62","author":"Girvigian","year":"2008"},{"key":"b8-0270011","series-title":"Neurosurgery","first-page":"446","article-title":"Results of linear accelerator-based radiosurgery for intracranial meningiomas","volume":"42","author":"Hakim","year":"1998"},{"key":"b9-0270011","series-title":"J Neurosurg","first-page":"511","article-title":"Meningiomas involving the sinus","volume":"105","author":"Heros","year":"2006"},{"key":"b10-0270011","series-title":"Neurosurgery","first-page":"179","article-title":"Peritumoral brain edema in meningiomas\u2014influence of vascular supply on its development","volume":"31","author":"Inamura","year":"1992"},{"key":"b11-0270011","series-title":"Neurosurgery","first-page":"405","article-title":"Judicious resection and\/or radiosurgery for parasagittal meningiomas: outcomes from a multicenter review. Gamma Knife Meningioma Study Group","volume":"43","author":"Kondziolka","year":"1998"},{"key":"b12-0270011","series-title":"J Neurosurg","first-page":"44","article-title":"Long-term outcomes after meningioma radiosurgery: physician and patient perspectives","volume":"91","author":"Kondziolka","year":"1999"},{"key":"b13-0270011","series-title":"Neurosurgery","first-page":"53","article-title":"Radiosurgery as definitive management of intracranial meningiomas","volume":"62","author":"Kondziolka","year":"2008"},{"key":"b14-0270011","series-title":"J Neurosurg","first-page":"187","article-title":"Contemporary management of meningiomas: radiation therapy as an adjuvant and radiosurgery as an alternative to surgical removal?","volume":"80","author":"Lunsford","year":"1994"},{"key":"b15-0270011","series-title":"Br J Neurosurg","first-page":"13","article-title":"The use of stereotactic radiosurgery in the management of meningiomas","volume":"19","author":"Malik","year":"2005"},{"issue":"Suppl 1","key":"b16-0270011","series-title":"Stereotact Funct Neurosurg","first-page":"142","article-title":"Gamma Knife radiosurgery for meningiomas: four cases of radiation-induced edema","volume":"66","author":"Nakamura","year":"1996"},{"key":"b17-0270011","series-title":"Clin Imaging","first-page":"243","article-title":"Meningiomas with brain edema: radiological characteristics on MRI and review of the literature","volume":"26","author":"Nakano","year":"2002"},{"issue":"Suppl 1","key":"b18-0270011","series-title":"Stereotact Funct Neurosurg","first-page":"19","article-title":"Early effects of Gamma Knife surgery on malignant and benign intracranial tumors","volume":"64","author":"Pan","year":"1995"},{"key":"b19-0270011","series-title":"Neurosurgery","first-page":"435","article-title":"Predictors of peritumoral edema after stereotactic radiosurgery of supratentorial meningiomas","volume":"63","author":"Patil","year":"2008"},{"key":"b20-0270011","series-title":"Neurosurgery","first-page":"295","article-title":"Cerebral edema associated with meningiomas: possible role of a secretory-excretory phenomenon","volume":"14","author":"Philippon","year":"1984"},{"key":"b21-0270011","series-title":"J Neurosurg","first-page":"514","article-title":"Results of attempted radical tumor removal and venous repair in 100 consecutive meningiomas involving the major dural sinuses","volume":"105","author":"Sindou","year":"2006"},{"issue":"3 Suppl","key":"b22-0270011","series-title":"J Neurosurg","first-page":"57","article-title":"Early complications following gamma knife radiosurgery for intracranial meningiomas","volume":"93","author":"Singh","year":"2000"},{"key":"b23-0270011","series-title":"Neurosurgery","first-page":"437","article-title":"Management of petroclival meningiomas by stereotactic radiosurgery","volume":"42","author":"Subach","year":"1998"},{"key":"b24-0270011","series-title":"J Neurosurg","first-page":"382","article-title":"Correlation between the efferent venous drainage of the tumor and peritumoral edema in intracranial meningiomas: superselective angiographic analysis of 25 cases","volume":"104","author":"Tanaka","year":"2006"},{"issue":"1 Suppl","key":"b25-0270011","series-title":"Stereotact Funct Neurosurg","first-page":"60","article-title":"A comparison of single fraction radiosurgery tumor control and toxicity in the treatment of basal and nonbasal meningiomas","volume":"72","author":"Vermeulen","year":"1999"},{"key":"b26-0270011","series-title":"Neurosurgery","first-page":"1405","article-title":"A diffuse white matter ischemic lesion appearing 7 years after stereotactic radiosurgery for cerebral arteriovenous malformations: case report","volume":"41","author":"Yamamoto","year":"1997"},{"key":"b1-0270011","series-title":"Neurosurgery","first-page":"1229","article-title":"Stereotactic radiosurgery for cavernous malformations: Kjellberg's experience with proton beam therapy in 98 cases at the Harvard cyclotron","volume":"42","author":"Amin-Hanjani","year":"1998"},{"key":"b2-0270011","series-title":"J Neurol Neurosurg Psychiatry","first-page":"226","article-title":"Complications after gamma knife radiosurgery for benign meningiomas","volume":"74","author":"Chang","year":"2003"},{"key":"b3-0270011","series-title":"Radiat Oncol","first-page":"46","article-title":"CyberKnife radiosurgery in the treatment of complex skull base tumors: analysis of treatment planning parameters","volume":"1","author":"Collins","year":"2006"},{"key":"b4-0270011","series-title":"Neurosurgery","first-page":"1263","article-title":"Meningiomas invading the superior sagittal sinus: surgical experience in 108 cases","volume":"55","author":"DiMeco","year":"2004"},{"key":"b5-0270011","series-title":"Acta Neurochir Suppl (Wien)","first-page":"92","article-title":"Radiosurgery for vascular malformations of the brain stem","volume":"58","author":"Duma","year":"1993"},{"issue":"1 Suppl","key":"b6-0270011","series-title":"Stereotact Funct Neurosurg","first-page":"129","article-title":"Radiation-induced edema after Gamma Knife treatment for meningiomas","volume":"66","author":"Ganz","year":"1996"},{"issue":"5 Suppl","key":"b7-0270011","series-title":"Neurosurgery","first-page":"A19","article-title":"Comparison of early complications for patients with convexity and parasagittal meningiomas treated with either stereotactic radiosurgery or fractionated stereotactic radiotherapy","volume":"62","author":"Girvigian","year":"2008"},{"key":"b8-0270011","series-title":"Neurosurgery","first-page":"446","article-title":"Results of linear accelerator-based radiosurgery for intracranial meningiomas","volume":"42","author":"Hakim","year":"1998"},{"key":"b9-0270011","series-title":"J Neurosurg","first-page":"511","article-title":"Meningiomas involving the sinus","volume":"105","author":"Heros","year":"2006"},{"key":"b10-0270011","series-title":"Neurosurgery","first-page":"179","article-title":"Peritumoral brain edema in meningiomas\u2014influence of vascular supply on its development","volume":"31","author":"Inamura","year":"1992"},{"key":"b11-0270011","series-title":"Neurosurgery","first-page":"405","article-title":"Judicious resection and\/or radiosurgery for parasagittal meningiomas: outcomes from a multicenter review. Gamma Knife Meningioma Study Group","volume":"43","author":"Kondziolka","year":"1998"},{"key":"b12-0270011","series-title":"J Neurosurg","first-page":"44","article-title":"Long-term outcomes after meningioma radiosurgery: physician and patient perspectives","volume":"91","author":"Kondziolka","year":"1999"},{"key":"b13-0270011","series-title":"Neurosurgery","first-page":"53","article-title":"Radiosurgery as definitive management of intracranial meningiomas","volume":"62","author":"Kondziolka","year":"2008"},{"key":"b14-0270011","series-title":"J Neurosurg","first-page":"187","article-title":"Contemporary management of meningiomas: radiation therapy as an adjuvant and radiosurgery as an alternative to surgical removal?","volume":"80","author":"Lunsford","year":"1994"},{"key":"b15-0270011","series-title":"Br J Neurosurg","first-page":"13","article-title":"The use of stereotactic radiosurgery in the management of meningiomas","volume":"19","author":"Malik","year":"2005"},{"issue":"Suppl 1","key":"b16-0270011","series-title":"Stereotact Funct Neurosurg","first-page":"142","article-title":"Gamma Knife radiosurgery for meningiomas: four cases of radiation-induced edema","volume":"66","author":"Nakamura","year":"1996"},{"key":"b17-0270011","series-title":"Clin Imaging","first-page":"243","article-title":"Meningiomas with brain edema: radiological characteristics on MRI and review of the literature","volume":"26","author":"Nakano","year":"2002"},{"issue":"Suppl 1","key":"b18-0270011","series-title":"Stereotact Funct Neurosurg","first-page":"19","article-title":"Early effects of Gamma Knife surgery on malignant and benign intracranial tumors","volume":"64","author":"Pan","year":"1995"},{"key":"b19-0270011","series-title":"Neurosurgery","first-page":"435","article-title":"Predictors of peritumoral edema after stereotactic radiosurgery of supratentorial meningiomas","volume":"63","author":"Patil","year":"2008"},{"key":"b20-0270011","series-title":"Neurosurgery","first-page":"295","article-title":"Cerebral edema associated with meningiomas: possible role of a secretory-excretory phenomenon","volume":"14","author":"Philippon","year":"1984"},{"key":"b21-0270011","series-title":"J Neurosurg","first-page":"514","article-title":"Results of attempted radical tumor removal and venous repair in 100 consecutive meningiomas involving the major dural sinuses","volume":"105","author":"Sindou","year":"2006"},{"issue":"3 Suppl","key":"b22-0270011","series-title":"J Neurosurg","first-page":"57","article-title":"Early complications following gamma knife radiosurgery for intracranial meningiomas","volume":"93","author":"Singh","year":"2000"},{"key":"b23-0270011","series-title":"Neurosurgery","first-page":"437","article-title":"Management of petroclival meningiomas by stereotactic radiosurgery","volume":"42","author":"Subach","year":"1998"},{"key":"b24-0270011","series-title":"J Neurosurg","first-page":"382","article-title":"Correlation between the efferent venous drainage of the tumor and peritumoral edema in intracranial meningiomas: superselective angiographic analysis of 25 cases","volume":"104","author":"Tanaka","year":"2006"},{"issue":"1 Suppl","key":"b25-0270011","series-title":"Stereotact Funct Neurosurg","first-page":"60","article-title":"A comparison of single fraction radiosurgery tumor control and toxicity in the treatment of basal and nonbasal meningiomas","volume":"72","author":"Vermeulen","year":"1999"},{"key":"b26-0270011","series-title":"Neurosurgery","first-page":"1405","article-title":"A diffuse white matter ischemic lesion appearing 7 years after stereotactic radiosurgery for cerebral arteriovenous malformations: case report","volume":"41","author":"Yamamoto","year":"1997"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/27\/5\/article-pE11.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/27\/5\/article-pE11.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/27\/5\/article-pE11.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:26:09Z","timestamp":1780129569000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/27\/5\/article-pE11.xml"}},"subtitle":["Technical note"],"short-title":[],"issued":{"date-parts":[[2009,11]]},"references-count":52,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2009.8.focus09-157","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,11]]}}}