Ces radiol. 2026, 80(1):16-19 | DOI: 10.55095/CesRadiol2026/015

Recommended MR protocol in ongoing safety monitoring of anti-amyloid therapy for early Alzheimer's disease - role of the neuroradiologistReview article

Martin Kynčl¹, Filip Cihlář², Josef Vymazal³, Pavel Ryška⁴, Marek Mechl⁵, Jiří Ferda⁶

¹ Klinika zobrazovacích metod 2. LF UK a FN Motol a Nemocnice Na Homolce, Praha

² Radiologická klinika Fakulty zdravotnických studií Univerzity J. E. Purkyně v Ústí nad Labem a Krajské zdravotní, a.s. - Masarykovy nemocnice v Ústí nad Labem, o.z.

³ Radiodiagnostické oddělení, Nemocnice Na Homolce, Praha

⁴ Radiologická klinika FN, Hradec Králové

⁵ Klinika radiologie a nukleární medicíny LF MU a FN, Brno-Bohunice

⁶ Klinika zobrazovacích metod, FN, Plzeň-Lochotín Korespondenční adresa:

^V Úvalu 84, 150 06 Praha 5 Konflikt zájmů: žádný.

Magnetic resonance imaging (MRI) remains the primary examination for patients with suspected Alzheimer's disease (AD), but in the era of anti-amyloid monoclonal antibodies, it is gaining new importance as a safety monitoring tool. The most common specific complication of anti-amyloid therapy is amyloid-related imaging abnormalities (ARIA), which are divided into ARIA-E (vasogenic edema and superficial effusion) and ARIA-H (microbleeds and cortical surface siderosis). Most ARIA is asymptomatic and detected during scheduled check-ups, but some cases may be symptomatic and mimic acute neurological conditions. Safe implementation of treatment therefore requires a standardized MR protocol (espe cially the inclusion of T2-FLAIR and SWI/T2* GRE sequences), consistent comparison with baseline examinations, uniform assessment of severity, and rapid communication of clinically significant findings. This review summarizes ARIA findings, MR protocol recommendations for their detection and description, and practical aspects of the neuroradiologist's role in multidisciplinary care for patients treated with anti-amyloid therapy.

Keywords: Alzheimer disease, amyloid-related imaging abnormalities, anti-amyloid antibodies, magnetic resonance imaging, microbleeds.

Accepted: February 15, 2026; Published: May 1, 2026  Show citation