Abstract #1794

ARIA Evaluation: physiological hallmarks of vascular alterations in patients undergoing anti-amyloid therapy

Zhe Sun^1,2, Li Jiang¹, Huize Pang¹, Chenyang Li¹, Hanzhang Lu³, Thomas Wisniewski⁴, and Yulin Ge¹

¹Center for Biomedical Imaging and Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, NYU Grossman School of Medicine, New York, NY, United States, ²Vilcek Institute of Graduate Biomedical Science, NYU Grossman School of Medicine, New York, NY, United States, ³Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States, ⁴Center for Cognitive Neurology, Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States

Synopsis

Keywords: Alzheimer's Disease, Treatment Response, Alzheimer's Disease, blood brain barrier, venous oxygenation

Motivation: Lecanemab treatment in patients with early Alzheimer's disease (AD) may compromise vascular integrity, potentially leading to amyloid-related imaging abnormalities (ARIA), a common side effect associated with anti-amyloid therapies.

Goal(s): To monitor vascular changes in ARIA, including blood-brain barrier (BBB) permeability and cerebral venous oxygenation (Yv), using non-contrast MRI.

Approach: BBB permeability and Yv were compared between PET-confirmed amyloid-positive patients treated with Lecanemab and age-matched untreated controls, as well as across two visits for treated patient.

Results: BBB permeability increased and Yv decreased in the second versus first scan for Lecanemab-treated patients. However, no significant differences were observed between treated and untreated subjects.

Impact: Advanced MRI techniques for assessing BBB permeability and venous oxygenation offer a quantitative approach in detecting early vascular and metabolic changes linked to anti-amyloid treatment, providing valuable insights and tools for monitoring amyloid-related imaging abnormalities (ARIA) and assessing ARIA risk.

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