A Shared Language for ARIA: Standardizing Alzheimer’s Imaging in the Age of New Therapies with RSNA

With the arrival of disease-modifying therapies for Alzheimer’s disease, we are entering a new era in neurodegenerative care. However, with innovation comes responsibility, particularly for radiologists who now play a pivotal role in ensuring treatment safety. One of their most urgent challenges? Consistently detecting and reporting Amyloid-Related Imaging Abnormalities (ARIA).

ARIA, specifically ARIA-E (edema) and ARIA-H (hemorrhage), are common imaging findings associated with anti-amyloid therapies. Detecting, grading, and reporting them accurately is essential, not only for patient safety but also for care coordination among neurologists, radiologists, and other specialists.

The Importance of ARIA in Alzheimer’s Treatment

As ARIA emerges in clinical practice with the rollout of anti-amyloid therapies, radiologists face a new diagnostic responsibility. Yet today, there is still no consistent approach to how ARIA findings are described or graded. Terminology and interpretation vary between institutions and even among individual radiologists. This lack of alignment creates communication gaps that can delay or compromise treatment decisions at a time when precision and clarity are essential.

Why a Shared Language for ARIA Matters

The inconsistency in ARIA reporting can lead to significant challenges in patient management. A shared language is crucial for effective communication among healthcare professionals. When radiologists use different terms or grading systems, it can result in misunderstandings and misinterpretations. This can ultimately affect patient care and treatment outcomes.

A Collaboration Between icometrix and RSNA to Standardize ARIA Monitoring

That’s why our CTO Dirk Smeets, in close collaboration with the Radiological Society of North America (RSNA), Marc Kohli (UCSF), Wende Gibbs (Barrow Neurological Institute), and Ali Tejani (UT Southwestern), led the development of the ARIA Common Data Elements (CDEs). This standardized set of terminology is designed to bring consistency and clarity to ARIA reporting.

These CDEs are now officially published by the Radiological Society of North America (RSNA) and are available publicly here: 🔗ARIA Common Data Elements on RadElement.org.

What the ARIA CDEs Enable

The ARIA CDEs define specific terms, measurements, and descriptors for radiologists to use when evaluating MRI scans for ARIA. By aligning on a standardized vocabulary, the healthcare system benefits in several key ways:

• Consistent diagnosis and grading of ARIA across institutions and vendors.

• Improved interdisciplinary communication between radiology, neurology, and clinical teams.

• More efficient reporting workflows and integration with structured reporting systems.

• Better patient outcomes, driven by faster and more informed decisions.

  
  

The RSNA’s adoption of these CDEs marks a significant step toward global standardization—and offers radiologists a clear framework for incorporating ARIA assessment into routine clinical practice.

Technology That Supports the Standard

While standardization sets the foundation, technology is essential to bring it into everyday practice. That’s where icobrain aria comes in.

icobrain aria is currently the only FDA-cleared and CE-marked AI solution capable of automatically detecting, quantifying, and grading both ARIA-E and ARIA-H. Built in alignment with the new ARIA CDEs, it empowers radiologists with automated, standardized analysis—making ARIA reporting faster, more objective, and more reliable. In an environment where Alzheimer’s treatments are becoming part of real-world care, imaging workflows need to evolve, and icobrain aria ensures they’re ready.

Collaboration That Moves the Field Forward

This milestone wouldn’t have been possible without the vision and input of leaders in the field. We’re deeply grateful to the Radiological Society of North America (RSNA), Marc Kohli, Ali Tejani, and Wende Gibbs for their collaboration and dedication to improving Alzheimer’s imaging.

The Future of Alzheimer’s Care

The future of Alzheimer’s care is here. As imaging becomes more central to therapy decisions, we’re proud to help define the standards that will ensure patients get the safest and most effective care possible. The integration of ARIA monitoring into clinical practice is not just a technical advancement; it represents a commitment to improving patient outcomes.

Conclusion

In conclusion, the emergence of disease-modifying therapies for Alzheimer’s disease presents both opportunities and challenges. Radiologists play a critical role in this new landscape, and the standardization of ARIA reporting is vital for ensuring patient safety and effective treatment. With tools like icobrain aria and the collaboration of key stakeholders, we are moving towards a future where Alzheimer’s care is more precise and informed than ever before.

As we continue to navigate this evolving field, the focus remains on enhancing the quality of care for patients. The journey ahead is promising, and together, we can make a difference.

*icobrain aria is 510(k) cleared. CE marked as part of icobrain mr. Not available in all markets.