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Clinical Manifestations.

Shenghua Zhu1, Jeremy N Ford1, Jarrel Seah1

  • 1Massachusetts General Hospital, Boston, MA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Portable low-field MRI shows promise for detecting amyloid-related imaging abnormalities (ARIA-E) in early Alzheimer's disease patients on lecanemab. This could improve timely monitoring and treatment decisions, overcoming limitations of conventional high-field MRI.

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Amyloid-related imaging abnormalities (ARIA), specifically ARIA-E (edema), are recognized complications in patients undergoing lecanemab treatment for early Alzheimer's disease (AD).
  • Prompt identification and surveillance of ARIA are crucial for ensuring patient safety and optimizing treatment efficacy.
  • Access to conventional high-field (HF) MRI for ARIA monitoring is often restricted by logistical challenges and high costs.

Purpose of the Study:

  • To evaluate the efficacy of portable low-field (LF) MRI in detecting and monitoring ARIA-E in patients with early AD receiving lecanemab.
  • To compare the diagnostic performance of LF MRI against standard HF MRI for ARIA-E assessment.

Main Methods:

  • Twenty patients with early AD on lecanemab treatment underwent 40 LF MRI scans (0.064 T).
  • HF MRI (3 T) scans closest in time served as the reference standard.
  • Four neuroradiologists assessed LF MRI scans for ARIA-E, and lesion dimensions/volumes were manually segmented and correlated with HF MRI findings.

Main Results:

  • LF MRI correctly identified ARIA-E in 2 of 20 patients and accurately identified ARIA-negative cases in 18 of 20.
  • Strong correlations were observed between LF MRI and HF MRI measurements for both maximal ARIA-E dimension (r=0.9239, p=0.0001) and volume (r=0.9562, p<0.0001).

Conclusions:

  • Portable LF MRI shows potential for detecting and monitoring ARIA-E in lecanemab-treated patients, potentially overcoming HF MRI accessibility issues.
  • Despite lower image quality than HF MRI, LF MRI's ability to facilitate prompt therapeutic decisions may hold significant clinical value.
  • Larger studies are needed to confirm these findings, optimize LF MRI protocols for ARIA screening, and establish its role in routine patient care.