Validation of an MRI Rating Scale for Amyloid-Related Imaging Abnormalities
Arianne Bechten1, Mike P Wattjes1, Derk D Purcell2,3
1Image Analysis Centre, Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands.
Summary
A new magnetic resonance imaging (MRI) scale for amyloid-related imaging abnormalities with edema and effusion (ARIA-E) shows high agreement among expert raters. This validated scale aids in assessing ARIA-E in patients undergoing amyloid beta-lowering therapies.
Area of Science:
- Neurology
- Radiology
- Pharmacology
Background:
- Immunotherapy targeting amyloid beta (Aβ) can cause adverse events like ARIA-E.
- A validated MRI rating scale is needed for ARIA-E detection and classification.
Purpose of the Study:
- To validate a newly developed MRI rating scale for ARIA-E in a larger patient cohort.
- To assess interrater agreement among neuroradiologists with varying expertise.
Main Methods:
- Five neuroradiologists evaluated MRI scans from 75 patients (29 with ARIA-E, 46 controls).
- The ARIA-E rating scale was applied to baseline and follow-up FLAIR images.
- Interrater agreement was quantified using the intraclass correlation coefficient (ICC).
Main Results:
- High interrater agreement was found for sulcal hyperintensity (SH; ICC=.915) and combined ARIA-E scores (ICC=.878).
- Agreement for parenchymal hyperintensity (PH) was slightly lower (ICC=.678).
- An average of 4.1% of ARIA-E cases were missed.
Conclusions:
- The ARIA-E MRI rating scale is a reliable tool for evaluating ARIA-E extent.
- The scale demonstrates high interrater reliability across different levels of expertise.
- This scale supports patient monitoring in Aβ-lowering therapeutic trials.
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