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SWI provides documented higher sensitivity and comparable or superior inter-rater reliability compared with conventional T2*GRE for detecting cerebral microbleeds and cortical superficial siderosis, the two key imaging manifestations of ARIA-H. Moreover, SWI is already incorporated into most contemporary dementia MRI protocols, offering important practical and logistical advantages. Available preliminary evidence suggests that the downstream clinical impact of detecting a few additional microbleeds or areas of siderosis may remain modest for most patients. Earlier and more reliable detection could potentially enhance safety by identifying individuals at higher risk of ARIA-H before treatment initiation. The critical requirements are transparency regarding sequence choice and consistency within individual patients over time.<\/jats:p>","DOI":"10.1007\/s00234-026-04138-x","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T12:33:06Z","timestamp":1788179586000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["SWI versus T2*GRE for ARIA-H monitoring: a pragmatic perspective on adoption in clinical practice"],"prefix":"10.1007","author":[{"given":"Meike W.","family":"Vernooij","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiago Gil","family":"Oliveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Wiest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick C.","family":"Fox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni B.","family":"Frisoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik","family":"Barkhof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"issue":"11","key":"4138_CR1","doi-asserted-by":"publisher","first-page":"4414","DOI":"10.1093\/brain\/awad188","volume":"146","author":"H Hampel","year":"2023","unstructured":"Hampel H, Elhage A, Cho M et al (2023) Amyloid-related imaging abnormalities (ARIA): radiological, biological and clinical characteristics. 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MWV has received speaker fees from Eisai and Lilly and is an advisory board member for Alzheimer Nederland. GBF has received consulting fees from Biogen, Diadem and Roche, and honoraria for lectures and educational activities from Biogen, Roche, Novo Nordisk and GE Healthcare (all through his institution). RW is an advisory board member for Eisai, Lilly and Bayer, and has received speaker honoraria from Lilly and Bayer. NCF has provided consultancy or served on advisory boards for Abbvie, Biogen, Eisai, Lilly and Roche (fees paid to his institution or donated to charity). He is a member of the Alzheimer\u2019s Society\u2019s Research Strategy Council (no fees). FB serves on steering committees or data safety monitoring boards for Biogen, Merck, Eisai and Prothena; is an advisory board member for Combinostics, Scottish Brain Sciences and Alzheimer Europe; has consulted for Roche, Celltrion, Rewind Therapeutics, Merck and Bracco; has research agreements with ADDI, Merck, Biogen, GE Healthcare and Roche; and is co-founder and shareholder of Queen Square Analytics Ltd.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}