RT Journal Article SR Electronic T1 An MRI Rating Scale for Amyloid-Related Imaging Abnormalities with Edema or Effusion JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 1550 OP 1555 DO 10.3174/ajnr.A3475 VO 34 IS 8 A1 F. Barkhof A1 M. Daams A1 P. Scheltens A1 H.R. Brashear A1 H.M. Arrighi A1 A. Bechten A1 K. Morris A1 M. McGovern A1 M.P. Wattjes YR 2013 UL http://www.ajnr.org/content/34/8/1550.abstract AB 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 “ARIA-E”), 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, 0–60). 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, 48–96) and sulcal hyperintensity (ICC = 0.89; 95% CI, 63–97) and for the combined scores of the 2 ARIA-E findings (ICC = 0.89; 95% CI, 62–97). Gyral swelling scores were observed to have lower inter-rater agreement (ICC = 0.54; 95% CI, −0.06–0.86). 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