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. 2022 Dec 2;14(1):e12376.
doi: 10.1002/dad2.12376. eCollection 2022.

Comparing ARIA-E severity scales and effects of treatment management thresholds

Gregory Klein  1 , Marzia A Scelsi  2 , Jerome Barakos  3 , Jochen B Fiebach  4 , Luc Bracoud  5 , Joyce Suhy  6 , Paul Delmar  1 , Marco Lyons  2 , Jakub Wojtowicz  1 , Szofia Bullain  1 , Frederik Barkhof  7   8 , Derk Purcell  3
Affiliations

Comparing ARIA-E severity scales and effects of treatment management thresholds

Gregory Klein et al. Alzheimers Dement (Amst). .

Abstract

Introduction: Amyloid-related imaging abnormalities-edema (ARIA-E) is associated with anti-amyloid beta monoclonal antibody treatment. ARIA-E severity may be assessed using the Barkhof Grand Total Scale (BGTS) or the 3- or 5-point Severity Scales of ARIA-E (SSAE-3/SSAE-5). We assessed inter- and intra-reader correlations between SSAE-3/5 and BGTS.

Methods: Magnetic resonance imaging scans were collected from 75 participants in the SCarlet RoAD and Marguerite RoAD studies. Three neuroradiologists reviewed scans at baseline and at follow-up. Concordance in dichotomized ARIA-E ratings was assessed for a range of BGTS thresholds.

Results: SSAE-3/5 scores correlated with BGTS scores, with high inter-reader intraclass correlation coefficients across all scales. There was high agreement in dichotomized ratings for SSAE-3 > 1 versus BGTS > 3 for all readers (accuracy 0.85-0.93) and between pairs of readers.

Discussion: SSAE-3/5 showed high degrees of correlation with BGTS, potentially allowing seamless transition from the BGTS to SSAE-3/5 for ARIA-E management.

Keywords: ARIA‐E; Alzheimer's disease; Barkhof Grand Total Scale; SSAE; Severity Scale of ARIA‐E; amyloid‐related imaging abnormalities; correlation; edema; magnetic resonance imaging.

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Conflict of interest statement

Gregory Klein is a full‐time employee and shareholder of F. Hoffmann‐La Roche Ltd. Marzia A. Scelsi is a full‐time employee of Roche Products Ltd. Jerome Barakos provides both consultative services and image interpretation for Clario. Jochen B. Fiebach reports outside the submitted work personal fees from AbbVie, AC Immune, Artemida, Bioclinica/Clario, Biogen, BMS, Brainomix, Cerevast, Daiichi‐Sankyo, Eisai, F. Hoffmann‐La Roche AG, Eli Lilly, Guerbet, Ionis Pharmaceuticals, IQVIA, Janssen, Julius Clinical, jung diagnostics, Lysogene, Merck, Nicolab, Premier Research, and Tau Rx. Luc Bracoud is a full‐time employee of Clario. Joyce Suhy is a full‐time employee of Clario. Paul Delmar is a full‐time employee and shareholder of F. Hoffmann‐La Roche Ltd. Marco Lyons is a full‐time employee and shareholder of Roche Products Ltd. Jakub Wojtowicz is a full‐time employee and shareholder of F. Hoffmann‐La Roche Ltd. Szofia Bullain is a full‐time employee and shareholder of F. Hoffmann‐La Roche Ltd. Frederik Barkhof is supported by the NIHR Biomedical Research Centre at UCLH. He is a steering committee or iDMC member for Biogen, Merck, Roche, EISAI, and Prothena; consultant for Roche, Biogen, Merck, IXICO, Janssen, and Combinostics; has research agreements with Roche, Merck, Biogen, and GE Healthcare; and is co‐founder and shareholder of Queen Square Analytics LTD. Derk Purcell reports outside the submitted work personal fees from Biogen and provides both consultative services and image interpretation for Clario. Author disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
Comparison of individual readers using the BGTS and SSAE‐3 (A) and using the BGTS and SSAE‐5 (B). Treatment thresholds of BGTS > 3 and SSAE‐3/ SSAE‐5 > 1 are marked in red. ARIA‐E, amyloid‐related imaging abnormalities–edema; BGTS, Barkhof Grand Total Scale; SSAE, Severity Scale of ARIA‐E
FIGURE 2
FIGURE 2
Concordance in dichotomized ratings comparing SSAE‐3 > 1 threshold with possible BGTS thresholds for individual readers. ARIA‐E, amyloid‐related imaging abnormalities–edema; BGTS, Barkhof Grand Total Scale; SSAE, Severity Scale of ARIA‐E
FIGURE 3
FIGURE 3
Examples where BGTS and SSAE ratings are concordant (top row) and discrepant (bottom row). BGTS, Barkhof Grand Total Scale; SSAE, Severity Scale of amyloid‐related imaging abnormalities–edema
See this image and copyright information in PMC

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