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. But 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.

Why a Shared Language for ARIA Matters

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.

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) - a standardized set of terminology 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 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.