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ARIA Training Module

CE / CME

Spot the Signal: Global Radiology Training for ARIA Detection in Alzheimer’s Care

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Physicians: Maximum of 1.00 AMA PRA Category 1 Credit™

European Learners: 1.00 EBAC® CE Credit

Released: April 16, 2026

Expiration: April 15, 2027

Tammie L. Benzinger
Tammie L. Benzinger, MD, PhD
Karl-Olof Lövblad
Karl-Olof Lövblad, MD
CME/CE Information

Activity

Progress
1 2 3
Course Completed

Case 1: Baseline Imaging

Dr Benzinger:

This is an example of a positive amyloid PET scan. There is very little uptake in the cerebellar cortex, but a lot of uptake in the white matter and in the gray matter. This would therefore be considered positive for amyloid pathology characteristic of AD.

Her brain MRI is mostly normal, except for relatively small temporal lobes and hippocampi. We are used to thinking about AD MRIs as having a lot of atrophy, so when we see a scan like this, we might initially think the patient does not have AD because the volume looks almost normal. We need to remember that the ATTs are used to treat patients at such an early stage of disease that only subtle changes might be present.

Dr Lövblad:

This represents a new paradigm for radiologists to see AD looking a little bit different from what we are used to, because we are now looking for and identifying it very early on.

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Case 1: Baseline MRI

Dr Benzinger:

This patient’s baseline MRI images do not show any microhemorrhages on SWI or GRE/T2*. Clinical trials were performed with T2*, but in most cases SWI has more sensitivity for small microhemorrhages. We perform both the SWI and the GRE/T2* routinely at our institution, because this helps calibrate what is seen in practice to what we know about from clinical trials and maximize findings.

FLAIR images reveal essentially a very close to normal FLAIR examination, potentially with some mild white matter hyperintensities, but not severe, and no signs of a prior infarct or other abnormality. Important things that we want to report on the baseline MRI include no microhemorrhages, no siderosis, no infarcts, and no other structural abnormalities.

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Case 1: ATT Monitoring MRI

Dr Benzinger:

This patient started receiving ATT therapy, and these are routine monitoring images before an infusion. The top row is the current exam; the bottom row is her prior exam. Arrows have been placed to clarify areas of interest.

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Would you report ARIA-E for this patient?

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