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38, 95% CI 1.58-3.60; P=.001) had a better obliteration rate. The cumulative 4-yr post-GKRS hemorrhage rates were 4.0% and 2.6% in the RA-GKRS and c-GKRS groups, respectively (P=.558). There was a trend toward early post-GKRS signal change in the RA-GKRS group compared with the c-GKRS group (cumulative rate, 38%vs 29% at 2 yr; P=.118). Those results were also confirmed in the matched cohort analyses. The integration of RA into GKRS is promising and may provide earlier nidus obliteration. The integration of RA into GKRS is promising and ma