Practical Brain MRI Guidelines for Anti-Aβ Antibody Treatment in Early Symptomatic Alzheimer's Disease

Magn Reson Med Sci. 2025 Nov 20;24(4):2025-1000. doi: 10.2463/mrms.gl.2025-1000. Epub 2025 Apr 5.

Abstract

Purpose: These guidelines aim to support MRI diagnosis in patients receiving anti-amyloid β (Aβ) antibody treatment without restricting treatment eligibility.

Materials and methods: These guidelines were collaboratively established by Japan Radiological Society, The Japanese Society of Neuroradiology, and Japanese Society for Magnetic Resonance in Medicine by reviewing existing literature and the results of clinical trials.

Results: Facility standards should comply with the "Optimal Use Promotion Guidelines" of Japan, and physicians should possess comprehensive knowledge of amyloid-related imaging abnormalities (ARIA) and expertise in brain MRI interpretation. The acquisition of knowledge regarding amyloid-related imaging abnormalities, brain MRI, anti-Aβ antibody introduction, and post-treatment diagnosis are also recommended.

Conclusion: These guidelines facilitate the accurate diagnosis and effective management of ARIA; ensure the safe administration of anti-Aβ drugs; and provide a framework for MRI facilities, includes staffing requirements and the use of MRI management systems.

Keywords: Alzheimer’s disease; amyloid-related imaging abnormalities; anti-amyloid beta antibody treatment; brain; guidelines; magnetic resonance imaging.

Publication types

  • Practice Guideline

MeSH terms

  • Alzheimer Disease* / diagnostic imaging
  • Alzheimer Disease* / drug therapy
  • Amyloid beta-Peptides* / immunology
  • Brain* / diagnostic imaging
  • Humans
  • Japan
  • Magnetic Resonance Imaging* / methods
  • Magnetic Resonance Imaging* / standards

Substances

  • Amyloid beta-Peptides