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.