PT  - JOURNAL ARTICLE
AU  - Barakos, J.
AU  - Sperling, R.
AU  - Salloway, S.
AU  - Jack, C.
AU  - Gass, A.
AU  - Fiebach, J.B.
AU  - Tampieri, D.
AU  - Melançon, D.
AU  - Miaux, Y.
AU  - Rippon, G.
AU  - Black, R.
AU  - Lu, Y.
AU  - Brashear, H.R.
AU  - Arrighi, H.M.
AU  - Morris, K.A.
AU  - Grundman, M.
TI  - MR Imaging Features of Amyloid-Related Imaging Abnormalities
AID  - 10.3174/ajnr.A3500
DP  - 2013 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1958--1965
VI  - 34
IP  - 10
4099  - http://www.ajnr.org/content/34/10/1958.short
4100  - http://www.ajnr.org/content/34/10/1958.full
SO  - Am. J. Neuroradiol.2013 Oct 01; 34
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