Sima, Diana M;
Phan, Thanh Vân;
Franceschi, Ana M;
Gibbs, Wende N;
Barkhof, Frederik;
Scheltens, Philip;
Salloway, Stephen;
... Smeets, Dirk; + view all
(2025)
Monitoring of amyloid related imaging abnormalities: SWI vs T2*-GRE.
The Journal of Prevention of Alzheimer's Disease
, Article 100220. 10.1016/j.tjpad.2025.100220.
(In press).
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Abstract
Amyloid-β-directed monoclonal antibody therapies may lead to amyloid-related imaging abnormalities (ARIA). Clinical trials that formed the basis for the ARIA radiographic severity grading scale adopted by the approved drugs' labels utilized T2* gradient recalled echo (T2*-GRE) images for ARIA-hemorrhagic (ARIA-H) assessment. Little is known about the application of susceptibility-weighted imaging (SWI) to ARIA-H assessment. We exploited comparative studies on the usage of SWI instead of 2D T2*-GRE and simulated the impact of SWI's higher sensitivity on the derived ARIA-H severity distribution for three approved drugs. The simulations indicated that the two sequences are not equivalent when grading ARIA-H severity and that the rate of therapy discontinuation would increase by more than 50% compared to the rates reported in the drugs' prescribing information. This should be taken into consideration whenever SWI is applied for ARIA safety monitoring. Appropriate imaging guidelines are needed to enhance management of amyloid-β-directed antibody therapies.
| Type: | Article |
|---|---|
| Title: | Monitoring of amyloid related imaging abnormalities: SWI vs T2*-GRE |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.tjpad.2025.100220 |
| Publisher version: | https://doi.org/10.1016/j.tjpad.2025.100220 |
| Language: | English |
| Additional information: | © 2025 The Authors. Published by Elsevier Masson SAS on behalf of SERDI Publisher. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) |
| Keywords: | Amyloid-related imaging abnormalities (hemorrhagic) (ARIA(-H)), Cerebral microbleeds (CMB), Superficial siderosis, Susceptibility weighted imaging (SWI), T2*-gradient recalled echo (T2*-GRE) |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10210455 |
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