TY - JOUR T1 - MR Imaging Features of Amyloid-Related Imaging Abnormalities JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. DO - 10.3174/ajnr.A3500 AU - J. Barakos AU - R. Sperling AU - S. Salloway AU - C. Jack AU - A. Gass AU - J.B. Fiebach AU - D. Tampieri AU - D. Melançon AU - Y. Miaux AU - G. Rippon AU - R. Black AU - Y. Lu AU - H.R. Brashear AU - H.M. Arrighi AU - K.A. Morris AU - M. Grundman Y1 - 2013/04/11 UR - http://www.ajnr.org/content/early/2013/04/11/ajnr.A3500.abstract N2 - 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. Abbreviations Aβamyloid-βADAlzheimer diseaseARIAamyloid-related imaging abnormalitiesARIA-Eamyloid-related imaging abnormalities associated with edema or effusion/exudateARIA-Hamyloid-related imaging abnormalities associated with hemosiderin deposition ER -