[Radiological Identification and Evaluation of Amyloid-Related Imaging Abnormalities in Alzheimer's Disease]

Amyloid-related imaging abnormalities (ARIA), intracranial signal abnormalities observed in magnetic resonance imaging (MRI), represent one of the main adverse events associated with treating Alzheimer's disease (AD) with anti-amyloid-β (anti-Aβ) monoclonal antibodies. In severe cases, patients' lives may be threatened. As the first anti-Aβ antibody was approved for use in China, clinical departments are now confronted with an increased likelihood of encountering ARIA in real-world scenarios. Accurate pre-treatment risk assessment, timely identification during medication, and severity evaluation of ARIA are of great significance in guiding clinical decisions. The identification and assessment of ARIA can be conducted from two perspectives-imaging and clinical symptoms. This article focuses on imaging. We reviewed the pathophysiological mechanisms, epidemiological and clinical characteristics, and imaging protocols and assessment of ARIA. We also stated at the end of the review that most current research data on ARIA came from clinical drug trials involving Caucasian populations, and that there was a lack of treatment experience in the real-world application of anti-Aβ monoclonal antibodies in Chinese populations. Many issues concerning pre-treatment risk assessment still need to be explored. Additionally, whether there are other clinical factors and imaging indicators that can help predict drug risks, and whether using different imaging protocols can help make a difference in patient management in the real world all require further investigation.