Differences in anti-amyloid therapy eligibility assessment based on use of the SWI versus GRE sequence.
4 affiliations
- 1Department of Neurology Mayo Clinic Rochester Minnesota USA.
- 2Department of Radiology Mayo Clinic Rochester Minnesota USA.
- 3Department of Neurosurgery Johns Hopkins University School of Medicine Baltimore Maryland USA.
- 4Department of Quantitative Health Science Mayo Clinic Rochester Minnesota USA.
Abstract
Introduction
The number of microhemorrhages (mHs) increases risk of amyloid-related imaging abnormalities (ARIAs) in those undergoing anti-amyloid treatments for Alzheimer's disease. It is unclear whether using different magnetic resonance imaging (MRI) sequences to detect mH would alter treatment decisions.Methods
We retrospectively analyzed 55 adults (mean age 72.1 ± 7.1 years) evaluated for cognitive concerns who had MRI exams including both susceptibility-weighted imaging (SWI) and gradient echo (GRE) sequences. Three neuroradiologists independently identified and then reached consensus on mH detection. Participants were classified into mH burden categories (none, 1, 2-4, ≥ 5).Results
Readers identified 83 mHs (mean 1.51) on SWI versus 54 (mean 0.98) on GRE. Burden categories agreed in 34 (61.8%) participants, was higher on SWI in 17 (30.9%) participants, and higher on GRE in 4 (7.3%) participants.Conclusions
Readers on average identified more mHs on SWI than GRE, altering risk categories. Prospective studies are needed to establish SWI-based safety thresholds for anti-amyloid therapies.
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BibTeX
@article{bermudez2026differences,
title = {{Differences in anti-amyloid therapy eligibility assessment based on use of the SWI versus GRE sequence.}},
author = {Camilo Bermudez and Jay J Pillai and Brian J Burkett and Jennifer S McDonald and Derek R Johnson and Heather J Wiste and Stephen D Weigand and Clifford R Jack and Prashanthi Vemuri and Ronald C Petersen and Jonathan Graff-Radford and Vijay K Ramanan and Petrice M Cogswell},
journal = {Alzheimer's \& dementia (Amsterdam, Netherlands)},
year = {2026},
month = oct,
doi = {10.1002/dad2.70524},
url = {https://europepmc.org/article/MED/42959393},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Differences in anti-amyloid therapy eligibility assessment based on use of the SWI versus GRE sequence.
AU - Camilo Bermudez
AU - Jay J Pillai
AU - Brian J Burkett
AU - Jennifer S McDonald
AU - Derek R Johnson
AU - Heather J Wiste
AU - Stephen D Weigand
AU - Clifford R Jack
AU - Prashanthi Vemuri
AU - Ronald C Petersen
AU - Jonathan Graff-Radford
AU - Vijay K Ramanan
AU - Petrice M Cogswell
PY - 2026
DA - 2026/10/28
JO - Alzheimer's & dementia (Amsterdam, Netherlands)
DO - 10.1002/dad2.70524
UR - https://europepmc.org/article/MED/42959393
AB - Introduction The number of microhemorrhages (mHs) increases risk of amyloid-related imaging abnormalities (ARIAs) in those undergoing anti-amyloid treatments for Alzheimer's disease. It is unclear whether using different magnetic resonance imaging (MRI) sequences to detect mH would alter treatment decisions.Methods We retrospectively analyzed 55 adults (mean age 72.1 ± 7.1 years) evaluated for cognitive concerns who had MRI exams including both susceptibility-weighted imaging (SWI) and gradient echo (GRE) sequences. Three neuroradiologists independently identified and then reached consensus on mH detection. Participants were classified into mH burden categories (none, 1, 2-4, ≥ 5).Results Readers identified 83 mHs (mean 1.51) on SWI versus 54 (mean 0.98) on GRE. Burden categories agreed in 34 (61.8%) participants, was higher on SWI in 17 (30.9%) participants, and higher on GRE in 4 (7.3%) participants.Conclusions Readers on average identified more mHs on SWI than GRE, altering risk categories. Prospective studies are needed to establish SWI-based safety thresholds for anti-amyloid therapies.
SN - 2352-8729
ER -