🧠 ARIA Brain Swelling Monitoring Simulator

Two Radiographic Signatures of Amyloid-Related Imaging Abnormalities

ARIA-E and ARIA-H are distinct MRI findings from anti-amyloid antibody therapy.

• ~20-35%: ARIA-E incidence (placeholder statistic)
• ~15-20%: ARIA-H incidence (placeholder statistic)
• FLAIR: MRI sequence for ARIA-E (placeholder statistic)
• GRE / SWI: MRI sequence for ARIA-H (placeholder statistic)

Distinguishing edema from hemorrhage on imaging

Placeholder: ARIA-E appears as FLAIR hyperintense edema/effusion; ARIA-H appears as GRE/SWI microhemorrhage or siderosis.

Scheduled MRI Surveillance Across the Anti-Amyloid Dosing Timeline

Placeholder: routine MRI checkpoints are timed around early high-risk infusions.

• Pre-dose 1: Baseline MRI (placeholder statistic)
• Doses 5-7: Peak risk window (placeholder statistic)
• 4+: Required scans (year 1) (placeholder statistic)
• FLAIR + GRE: Sequences per scan (placeholder statistic)

Timing of surveillance scans relative to dosing

Placeholder: MRIs are scheduled before dose 1 and around doses 5, 7, and 14 to catch peak ARIA incidence.

APOE4 Carrier Status as the Dominant ARIA Risk Modifier

Placeholder: APOE4 allele dose increases ARIA incidence and severity risk.

• ~8%: Non-carrier ARIA-E (placeholder statistic)
• ~15%: Heterozygous ARIA-E (placeholder statistic)
• ~30-40%: Homozygous ARIA-E (placeholder statistic)
• Recommended: Genetic counseling (placeholder statistic)

Allele dose effect on ARIA incidence

Placeholder: homozygous APOE4 carriers show markedly higher ARIA-E and ARIA-H rates than non-carriers.

Radiographic Grading Scales for ARIA-E and ARIA-H Findings

Placeholder: mild, moderate, and severe grades are defined by lesion extent.

• <5 cm: ARIA-E mild (placeholder statistic)
• >10 cm / multifocal: ARIA-E severe (placeholder statistic)
• ≤4 microhemorrhages: ARIA-H mild (placeholder statistic)
• >10 or large lesion: ARIA-H severe (placeholder statistic)

Grading criteria used by radiologists

Placeholder: severity grade combines lesion size, number of foci, and symptom presence.

When to Pause, Resume, or Permanently Discontinue Therapy

Placeholder: dosing decisions follow severity-based clinical algorithms.

• Continue: Mild asymptomatic ARIA (placeholder statistic)
• Pause dosing: Moderate ARIA (placeholder statistic)
• Discontinue: Severe/symptomatic ARIA (placeholder statistic)
• Radiographic resolution: Resumption criteria (placeholder statistic)

Decision algorithm for dose management

Placeholder: resumption requires imaging resolution and clinician risk-benefit reassessment.

Placeholder: severe symptomatic ARIA typically leads to permanent discontinuation.