Six‐month follow‐up of ARIA‐H and iron deposition in real‐world lecanemab therapy for Alzheimer's disease: Evidence from a Chinese 7T MRI cohort

作者：Wen Zhang, Haokun Liu, Chenze Zhang, Yulai Li, Keying Fang, Yafang Zhou, Ling Weng, Liangjuan Fang, Yingying Luo, Han Xiao, Lin Zhou, Bin Jiao, Lu Shen · 发表于：Alzheimer s & Dementia · 年份：2025 · DOI：10.1002/alz.71044 · 被引用次数：3 · 研究领域：Dementia and Cognitive Impairment Research、Intracerebral and Subarachnoid Hemorrhage Research、Alzheimer's disease research and treatments

INTRODUCTION: With the approval of lecanemab for treating Alzheimer's disease (AD), there is an urgent need to evaluate its safety and treatment effects on biomarkers in real-world practice. METHODS: Patients receiving lecanemab (n = 72) underwent routine 3T and 7T magnetic resonance imaging (MRI) for amyloid-related imaging abnormality (ARIA) monitoring. Longitudinal changes of iron deposition assessed by quantitative susceptibility mapping (QSM) and its association with plasma biomarkers were further evaluated. RESULTS: With use of 7T MRI, we identified characteristic perivascular features and detected ARIA with hemorrhages/hemosiderin deposition (ARIA-H) ≈4 months earlier than with 3T. QSM detected post-treatment regional susceptibility reductions. Decreased susceptibility in the temporal, frontal lobes, and the thalamus was associated with plasma amyloid beta 42 (Aβ42) and tau phosphorylated at threonine 217 (p-tau217) changes. DISCUSSION: 7T MRI provides superior ARIA-H detection and iron dynamics monitoring, supporting its role in risk stratification and therapy assessment for lecanemab-treated patients. Iron deposition measured by QSM may serve as a promising neuroimaging marker for amyloid-targeting treatments. HIGHLIGHTS: Using 7T magnetic resonance imaging (MRI), this study for the first time visualized amyloid-related imaging abnormality with hemorrhages/hemosiderin deposition (ARIA-H) at a submillimeter resolution, characterized by aggregated, clustered cerebral m...