Validation of an MRI Rating Scale for Amyloid-Related Imaging Abnormalities

Arianne Bechten, Mike P. Wattjes, Derk D. Purcell, Esther Sanchez Aliaga, Marita Daams, H. Robert Brashear, H. Michael Arrighi, Frederik Barkhof

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

INTRODUCTION: Immunotherapeutic agents against amyloid beta (Aβ) are associated with adverse events, including amyloid-related imaging abnormalities with edema and effusion (ARIA-E). Recently, a magnetic resonance imaging (MRI) rating scale was developed for ARIA-E detection and classification. The aim of this study was to validate the use of this rating scale in a larger patient group with multiple raters. METHODS: MRI scans of 75 patients (29 with known ARIA-E and 46 control subjects) were analyzed by five neuroradiologists with different degrees of expertise, according to the ARIA-E rating scale. For each patient, we included a baseline and a follow-up fluid-attenuated inversion recovery image. Interrater agreement was calculated using intraclass correlation coefficient (ICC). RESULTS: On average, 4.1% of the ARIA-E cases were missed. We observed a high interrater agreement for scores of sulcal hyperintensity (SH; ICC =.915; 95% CI 85–95) and for the combined scores of the 2 ARIA-E findings, parenchymal hyperintensity (PH) and SH (ICC =.878; 95% CI 79–93). A slightly lower agreement for PH (ICC =.678; 95% CI 51–81) was noted. CONCLUSION: The ARIA-E rating scale is a simple tool to evaluate the extent of ARIA-E in patients recruited into Aβ-lowering therapeutic trials. It shows high interrater agreement among raters with different degrees of expertise.

Original languageEnglish
Pages (from-to)318-325
Number of pages8
JournalJournal of Neuroimaging
Volume27
Issue number3
DOIs
Publication statusPublished - 1 May 2017

Cite this

Bechten, Arianne ; Wattjes, Mike P. ; Purcell, Derk D. ; Aliaga, Esther Sanchez ; Daams, Marita ; Brashear, H. Robert ; Arrighi, H. Michael ; Barkhof, Frederik. / Validation of an MRI Rating Scale for Amyloid-Related Imaging Abnormalities. In: Journal of Neuroimaging. 2017 ; Vol. 27, No. 3. pp. 318-325.
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title = "Validation of an MRI Rating Scale for Amyloid-Related Imaging Abnormalities",
abstract = "INTRODUCTION: Immunotherapeutic agents against amyloid beta (Aβ) are associated with adverse events, including amyloid-related imaging abnormalities with edema and effusion (ARIA-E). Recently, a magnetic resonance imaging (MRI) rating scale was developed for ARIA-E detection and classification. The aim of this study was to validate the use of this rating scale in a larger patient group with multiple raters. METHODS: MRI scans of 75 patients (29 with known ARIA-E and 46 control subjects) were analyzed by five neuroradiologists with different degrees of expertise, according to the ARIA-E rating scale. For each patient, we included a baseline and a follow-up fluid-attenuated inversion recovery image. Interrater agreement was calculated using intraclass correlation coefficient (ICC). RESULTS: On average, 4.1{\%} of the ARIA-E cases were missed. We observed a high interrater agreement for scores of sulcal hyperintensity (SH; ICC =.915; 95{\%} CI 85–95) and for the combined scores of the 2 ARIA-E findings, parenchymal hyperintensity (PH) and SH (ICC =.878; 95{\%} CI 79–93). A slightly lower agreement for PH (ICC =.678; 95{\%} CI 51–81) was noted. CONCLUSION: The ARIA-E rating scale is a simple tool to evaluate the extent of ARIA-E in patients recruited into Aβ-lowering therapeutic trials. It shows high interrater agreement among raters with different degrees of expertise.",
keywords = "Alzheimer's disease (AD), amyloid beta (Aβ), ARIA (amyloid-related imaging abnormalities), immunotherapy, MRI (magnetic resonance imaging)",
author = "Arianne Bechten and Wattjes, {Mike P.} and Purcell, {Derk D.} and Aliaga, {Esther Sanchez} and Marita Daams and Brashear, {H. Robert} and Arrighi, {H. Michael} and Frederik Barkhof",
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Validation of an MRI Rating Scale for Amyloid-Related Imaging Abnormalities. / Bechten, Arianne; Wattjes, Mike P.; Purcell, Derk D.; Aliaga, Esther Sanchez; Daams, Marita; Brashear, H. Robert; Arrighi, H. Michael; Barkhof, Frederik.

In: Journal of Neuroimaging, Vol. 27, No. 3, 01.05.2017, p. 318-325.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Validation of an MRI Rating Scale for Amyloid-Related Imaging Abnormalities

AU - Bechten, Arianne

AU - Wattjes, Mike P.

AU - Purcell, Derk D.

AU - Aliaga, Esther Sanchez

AU - Daams, Marita

AU - Brashear, H. Robert

AU - Arrighi, H. Michael

AU - Barkhof, Frederik

PY - 2017/5/1

Y1 - 2017/5/1

N2 - INTRODUCTION: Immunotherapeutic agents against amyloid beta (Aβ) are associated with adverse events, including amyloid-related imaging abnormalities with edema and effusion (ARIA-E). Recently, a magnetic resonance imaging (MRI) rating scale was developed for ARIA-E detection and classification. The aim of this study was to validate the use of this rating scale in a larger patient group with multiple raters. METHODS: MRI scans of 75 patients (29 with known ARIA-E and 46 control subjects) were analyzed by five neuroradiologists with different degrees of expertise, according to the ARIA-E rating scale. For each patient, we included a baseline and a follow-up fluid-attenuated inversion recovery image. Interrater agreement was calculated using intraclass correlation coefficient (ICC). RESULTS: On average, 4.1% of the ARIA-E cases were missed. We observed a high interrater agreement for scores of sulcal hyperintensity (SH; ICC =.915; 95% CI 85–95) and for the combined scores of the 2 ARIA-E findings, parenchymal hyperintensity (PH) and SH (ICC =.878; 95% CI 79–93). A slightly lower agreement for PH (ICC =.678; 95% CI 51–81) was noted. CONCLUSION: The ARIA-E rating scale is a simple tool to evaluate the extent of ARIA-E in patients recruited into Aβ-lowering therapeutic trials. It shows high interrater agreement among raters with different degrees of expertise.

AB - INTRODUCTION: Immunotherapeutic agents against amyloid beta (Aβ) are associated with adverse events, including amyloid-related imaging abnormalities with edema and effusion (ARIA-E). Recently, a magnetic resonance imaging (MRI) rating scale was developed for ARIA-E detection and classification. The aim of this study was to validate the use of this rating scale in a larger patient group with multiple raters. METHODS: MRI scans of 75 patients (29 with known ARIA-E and 46 control subjects) were analyzed by five neuroradiologists with different degrees of expertise, according to the ARIA-E rating scale. For each patient, we included a baseline and a follow-up fluid-attenuated inversion recovery image. Interrater agreement was calculated using intraclass correlation coefficient (ICC). RESULTS: On average, 4.1% of the ARIA-E cases were missed. We observed a high interrater agreement for scores of sulcal hyperintensity (SH; ICC =.915; 95% CI 85–95) and for the combined scores of the 2 ARIA-E findings, parenchymal hyperintensity (PH) and SH (ICC =.878; 95% CI 79–93). A slightly lower agreement for PH (ICC =.678; 95% CI 51–81) was noted. CONCLUSION: The ARIA-E rating scale is a simple tool to evaluate the extent of ARIA-E in patients recruited into Aβ-lowering therapeutic trials. It shows high interrater agreement among raters with different degrees of expertise.

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KW - amyloid beta (Aβ)

KW - ARIA (amyloid-related imaging abnormalities)

KW - immunotherapy

KW - MRI (magnetic resonance imaging)

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DO - 10.1111/jon.12422

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JO - Journal of Neuroimaging

JF - Journal of Neuroimaging

SN - 1051-2284

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