J Korean Soc Radiol.
2025 Jan;86(1):17-33. 10.3348/jksr.2024.0140.
Anti-Amyloid Imaging Abnormality in the Era of Anti-Amyloid Beta Monoclonal Antibodies: Recent Updates for the Radiologist
- Affiliations
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- 1Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- 2Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 3Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- KMID: 2564850
- DOI: http://doi.org/10.3348/jksr.2024.0140
Abstract
- Lecanemab and donanemab have received full U.S. Food and Drug Administration (FDA) approval, and subsequently, lecanemab has been approved by the Korean FDA and it has recently entered commercial use in Korea. This has increased interest in anti-amyloid immunotherapy for Alzheimer’s disease. Anti-amyloid immunotherapy has shown potential to modify the progression of the disease by specifically binding to amyloid β, a key pathological product in Alzheimer’s disease, and eliminating accumulated amyloid plaques in the brain. However, this treatment can be accompanied by a side-effect, amyloid-related imaging abnormalities (ARIA), which requires periodic monitoring by MRI. It is crucial to detect ARIA and accurately assess the severity by radiology. The role of the radiologist is important in this context, requiring proficiency in basic knowledge of ARIA, and in diagnosing/evaluating ARIA. This review aims to comprehensively cover aspects of ARIA, including its definition, pathophysiology, incidence, risk factors, assessment of severity by radiology, differential diagnosis, and management.
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