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Baseline Amyloid PET Centiloid Score and Risk of Amyloid-Related Imaging Abnormalities in Patients Treated With Lecanemab
Dowling T, Zhu S, Ford J, Ganem Chagui O, Omid-Fard N, Martinez Imbett RE, Wleklinski M, Yu E et al.. AJNR. American journal of neuroradiology, 2026-08-13
Topic: Amyloid, tau and blood-test diagnosis
Plain-language summary
Background and purpose Amyloid-related imaging abnormalities (ARIA) are a known complication of anti-amyloid monoclonal antibody therapy for Alzheimer's disease. Centiloid score, derived from amyloid PET/CT, provides a quantitative assessment of baseline amyloid burden; however, its relationship with ARIA risk remains uncertain. This study evaluated whether baseline Centiloid score was associated with ARIA in patients treated with lecanemab and included a secondary exploratory analysis of regional amyloid uptake. Materials and methods We retrospectively identified patients treated with lecanemab within a single academic health system who underwent pretreatment florbetaben amyloid PET/CT. Centiloid scores were generated using a standardized processing pipeline. Multivariable logistic regression evaluated the association between baseline Centiloid and ARIA, adjusting for age, sex, APOE ε4 carrier status, and baseline cerebral microbleed presence. ARIA-H and ARIA-E subgroups were evaluated separately using Firth penalized logistic regression. A secondary Cox proportional hazards analysis accounted for unequal follow up durations. Exploratory regional analysis compared baseline amyloid uptake in regions that subsequently developed ARIA-E with that in mirrored contralateral regions. Results The primary analysis included 41 patients with ARIA and 72 controls who completed at least 14 lecanemab infusions without ARIA. Baseline Centiloid was not independently associated with ARIA (adjusted OR per 10-Centiloid increase, 1.01 [95% CI, 0.89-1.15]; P = .90), ARIA-H (OR, 1.01 [95% CI, 0.89-1.14]; P = .91), or ARIA-E (OR, 1.02 [95% CI, 0.87-1.21]; P = .78). In the Cox analysis of 41 patients with ARIA and 100 patients without ARIA, baseline Centiloid was not associated with time to ARIA (adjusted HR, 1.01 [95% CI, 0.91-1.11]; P = .91). Among 19 patients with ARIA-E included in the regional analysis, baseline uptake was modestly greater in regions that subsequently developed ARIA-E than in mirrored contralateral regions for SUVmax (3.44 ± 0.78 versus 3.25 ± 0.77; P = .02) and SUVmean (2.60 ± 0.56 versus 2.45 ± 0.64; P = .01). Conclusions Baseline global Centiloid was not independently associated with ARIA in patients treated with lecanemab. Exploratory regional analysis demonstrated modest differences in baseline amyloid uptake in regions that subsequently developed ARIA-E, warranting confirmation in larger prospective studies.
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APA 7th
Dowling, T., Zhu, S., Ford, J., Ganem Chagui, O., Omid-Fard, N., Martinez Imbett, R. E., et al. (2026). Baseline Amyloid PET Centiloid Score and Risk of Amyloid-Related Imaging Abnormalities in Patients Treated With Lecanemab. AJNR. American journal of neuroradiology. https://doi.org/10.3174/ajnr.a9590
Vancouver
Dowling T, Zhu S, Ford J, Ganem Chagui O, Omid-Fard N, Martinez Imbett RE, et al. Baseline Amyloid PET Centiloid Score and Risk of Amyloid-Related Imaging Abnormalities in Patients Treated With Lecanemab. AJNR. American journal of neuroradiology. 2026. doi:10.3174/ajnr.a9590. PMID: 42595466.
BibTeX
@article{dowling2026-42595466,
author = {Dowling, T. and Zhu, S. and Ford, J. and Ganem Chagui, O. and Omid-Fard, N. and Martinez Imbett, R. E. and Wleklinski, M. and Yu, E. and others},
title = {{Baseline Amyloid PET Centiloid Score and Risk of Amyloid-Related Imaging Abnormalities in Patients Treated With Lecanemab}},
journal = {AJNR. American journal of neuroradiology},
year = {2026},
doi = {10.3174/ajnr.a9590},
pmid = {42595466},
url = {https://doi.org/10.3174/ajnr.a9590}
}
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Key findings
- This study evaluated whether baseline Centiloid score was associated with ARIA in patients treated with lecanemab and included a secondary exploratory analysis of regional amyloid uptake.
- Results The primary analysis included 41 patients with ARIA and 72 controls who completed at least 14 lecanemab infusions without ARIA.
- Baseline Centiloid was not independently associated with ARIA (adjusted OR per 10-Centiloid increase, 1.01 [95% CI, 0.89-1.15]; P = .90), ARIA-H (OR, 1.01 [95% CI, 0.89-1.14]; P = .91), or ARIA-E (OR, 1.02 [95% CI, 0.87-1.21]; P = .78).
- In the Cox analysis of 41 patients with ARIA and 100 patients without ARIA, baseline Centiloid was not associated with time to ARIA (adjusted HR, 1.01 [95% CI, 0.91-1.11]; P = .91).
- Among 19 patients with ARIA-E included in the regional analysis, baseline uptake was modestly greater in regions that subsequently developed ARIA-E than in mirrored contralateral regions for SUVmax (3.44 ± 0.78 versus 3.25 ± 0.77; P = .02) and SUVmean (2.60 ± 0.56 versus 2.45 ± 0.64; P = .01).
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Study details
- Participants41
- Evidence strengthLow
How this study scored 50/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 29 of the 58 points we could judge it on, which is 50 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (AJNR. American journal of neuroradiology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 1 / 4 | 41 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42595466) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 29 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 29 of the 58 points we could judge it on is 50 out of 100. |
| Total | 50 / 100 | — |
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