Sato Kenichiro, Niimi Yoshiki, Ihara Ryoko, Iwata Atsushi, Iwatsubo Takeshi
Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
Unit for Early and Exploratory Clinical Development, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
Biomedicines. 2024 Aug 16;12(8):1870. doi: 10.3390/biomedicines12081870.
(1) Background: The 2023 approval of lecanemab for early-stage Alzheimer's disease (AD) highlighted the need for routine 1.5T or 3.0T MRI scans to monitor amyloid-related imaging abnormalities (ARIAs). Regional disparities in MRI scan frequency, MRI scanner availability, and scanner magnetic field strengths could affect readiness for anti-amyloid therapy and lead to inconsistencies in ARIA detection nationwide. (2) Methods: We assessed regional variance in MRI scan frequency and field strength across Japan using the National Database (NDB) Open Data website, which summarizes Japanese public health insurance claims from the fiscal years (FYs) 2015 to 2021. We employed a mixed-effects model with prefecture-level random intercepts and slopes over time, subsequently categorizing prefectures into clusters based on MRI usage. (3) Results: 1.5T MRI was the most common magnetic field strength, remaining stable from FY2015 to FY2021. 3.0T MRI usage slightly increased, although the COVID-19 pandemic in FY2020 led to a maximum reduction of 5%. Prefecture-level variance was higher for 3.0T MRIs, with more frequent usage in western Japan. (4) Conclusions: This study highlights prefecture-level variance in MRI usage across Japan. The insights gained could be instrumental in improving healthcare preparedness for anti-amyloid treatment and patient management.
(1) 背景：2023年，lecanemab被批准用于早期阿尔茨海默病（AD），这凸显了进行常规1.5T或3.0T磁共振成像（MRI）扫描以监测淀粉样蛋白相关成像异常（ARIAs）的必要性。MRI扫描频率、MRI扫描仪可用性以及扫描仪磁场强度的地区差异可能会影响抗淀粉样蛋白治疗的准备情况，并导致全国范围内ARIAs检测的不一致。(2) 方法：我们使用国家数据库（NDB）开放数据网站评估了日本各地MRI扫描频率和场强的地区差异，该网站汇总了2015财年至2021财年日本公共医疗保险理赔数据。我们采用了一个混合效应模型，其中包含县级随机截距和随时间变化的斜率，随后根据MRI使用情况将各县分为不同类别。(3) 结果：1.5T MRI是最常见的磁场强度，从2015财年到2021财年保持稳定。3.0T MRI的使用略有增加，尽管2020财年的新冠疫情导致其使用量最多减少了5%。3.0T MRI的县级差异更大，在日本西部使用更频繁。(4) 结论：本研究突出了日本各地MRI使用的县级差异。所获得的见解可能有助于提高抗淀粉样蛋白治疗的医疗准备和患者管理水平。
