RT Journal Article
SR Electronic
T1 MR Imaging Features of Amyloid-Related Imaging Abnormalities
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1958
OP 1965
DO 10.3174/ajnr.A3500
VO 34
IS 10
A1 Barakos, J.
A1 Sperling, R.
A1 Salloway, S.
A1 Jack, C.
A1 Gass, A.
A1 Fiebach, J.B.
A1 Tampieri, D.
A1 Melançon, D.
A1 Miaux, Y.
A1 Rippon, G.
A1 Black, R.
A1 Lu, Y.
A1 Brashear, H.R.
A1 Arrighi, H.M.
A1 Morris, K.A.
A1 Grundman, M.
YR 2013
UL http://www.ajnr.org/content/34/10/1958.abstract
AB BACKGROUND AND PURPOSE: AD is one of the few leading causes of death without a disease-modifying drug; however, hopeful agents are in various phases of development. MR imaging abnormalities, collectively referred to as amyloid-related imaging abnormalities, have been reported for several agents that target cerebral Aβ burden. ARIA includes ARIA-E, parenchymal or sulcal hyperintensities on FLAIR indicative of parenchymal edema or sulcal effusions, and ARIA-H, hypointense regions on gradient recalled-echo/T2* indicative of hemosiderin deposition. This report describes imaging characteristics of ARIA-E and ARIA-H identified during studies of bapineuzumab, a humanized monoclonal antibody against Aβ. MATERIALS AND METHODS: Two neuroradiologists with knowledge of imaging changes reflective of ARIA reviewed MR imaging scans from 210 bapineuzumab-treated patients derived from 3 phase 2 studies. Each central reader interpreted the studies independently, and discrepancies were resolved by consensus. The inter-reader κ was 0.76, with 94% agreement between neuroradiologists regarding the presence or absence of ARIA-E in individual patients. RESULTS: Thirty-six patients were identified with incident ARIA-E (17.1%, 36/210) and 26 with incident ARIA-H (12.4%, 26/210); of those with incident ARIA-H, 24 had incident microhemorrhages and 2 had incident large superficial hemosiderin deposits. CONCLUSIONS: In 49% of cases of ARIA-E, there was the associated appearance of ARIA-H. In treated patients without ARIA-E, the risk for incident blood products was 4%. This association between ARIA-E and ARIA-H may suggest a common pathophysiologic mechanism. Familiarity with ARIA should permit radiologists and clinicians to recognize and communicate ARIA findings more reliably for optimal patient management. Aβamyloid-βADAlzheimer diseaseARIAamyloid-related imaging abnormalitiesARIA-Eamyloid-related imaging abnormalities associated with edema or effusion/exudateARIA-Hamyloid-related imaging abnormalities associated with hemosiderin deposition