@article {Barkhof1550, author = {F. Barkhof and M. Daams and P. Scheltens and H.R. Brashear and H.M. Arrighi and A. Bechten and K. Morris and M. McGovern and M.P. Wattjes}, title = {An MRI Rating Scale for Amyloid-Related Imaging Abnormalities with Edema or Effusion}, volume = {34}, number = {8}, pages = {1550--1555}, year = {2013}, doi = {10.3174/ajnr.A3475}, publisher = {American Journal of Neuroradiology}, abstract = {BACKGROUND AND PURPOSE: Immune therapy against amyloid-β appears to be a promising target in Alzheimer disease. However, a dose-related risk for ARIA on FLAIR images thought to represent parenchymal vasogenic edema or sulcal effusion (termed {\textquotedblleft}ARIA-E{\textquotedblright}), has been observed in clinical trials. To assess the intensity of ARIA-E presentation, an MR imaging scale that is both reproducible and easily implemented would assist in monitoring and evaluating this adverse event. MATERIALS AND METHODS: On the basis of a review of existing cases from a phase II bapineuzumab study, a scale was constructed with a 6-point score for the 6 regions on each side of the brain (range, 0{\textendash}60). Scores would be obtained for both parenchymal and sulcal hyperintensities and frequently co-occurring gyral swelling. Inter-rater reliability between 2 neuroradiologists was evaluated in 20 patients, 10 with known ARIA-E and 10 without, by using the intraclass correlation coefficient. RESULTS: The 2 raters had excellent agreement in the identification of ARIA-E cases. A high inter-rater agreement was observed for scores of parenchymal hyperintensity (ICC = 0.83; 95\% CI, 48{\textendash}96) and sulcal hyperintensity (ICC = 0.89; 95\% CI, 63{\textendash}97) and for the combined scores of the 2 ARIA-E findings (ICC = 0.89; 95\% CI, 62{\textendash}97). Gyral swelling scores were observed to have lower inter-rater agreement (ICC = 0.54; 95\% CI, -0.06{\textendash}0.86). CONCLUSIONS: The proposed rating scale provides a reliable and easily implemented instrument to grade ARIA-E imaging findings. We currently do not recommend including swelling. Aβamyloid-betaADAlzheimer diseaseApoEapolipoprotein EARIAamyloid-related imaging abnormalitiesICCintraclass correlation coefficient}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/34/8/1550}, eprint = {https://www.ajnr.org/content/34/8/1550.full.pdf}, journal = {American Journal of Neuroradiology} }