Amyloid-related imaging abnormalities associated with immunotherapy in Alzheimer’s disease patients

Evaluation of: Sperling R, Salloway S, Brooks DJ et al. Amyloid-related imaging abnormalities in patients with Alzheimer’s disease treated with bapineuzumab: a retrospective analysis. Lancet Neurol. 11(3), 241–249 (2012). Amyloid-related imaging abnormalities (ARIAs) have been reported in patients with Alzheimer’s disease treated with bapineuzumab, a monoclonal antibody targeting β-amyloid (Aβ). The spectrum of ARIA includes signal hyperintensities on fluid attenuation inversion recovery sequences thought to represent ‘vasogenic edema’ and/or sulcal effusion (ARIA-E), as well as signal hypointensities on gradient echo/T2* thought to represent hemosiderin deposits. This study was a retrospective analysis in which two neuroradiologists independently reviewed 2572 fluid attenuation inversion recovery MRI scans from 262 participants in two Phase II studies of bapineuzumab and an open-label extension study. In this analysis, several ARIA-E cases were identified that were initially missed in the reported studie...