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Rapid RASER MRI

Conventional Magnetic Resonance Imaging (MRI) relies on high-power Radio-Frequency (RF) pulses to excite nuclear spins and in turn generate NMR signals. These pulses require large high-power RF-amplifiers and cause heat deposition in the tissue, which must be minimized for safety, presenting a growing problem when moving toward ever-higher field MRI. An alternative to RF-pulse excitation is self-excitation of nuclear spins using Radiofrequency Amplification by Stimulated Emission of Radiation (RASER), where the nuclear spins undergo spontaneous transition, without RF excitation, from an over-populated state to a ground state. Here, the feasibility of recording rapid proton RASER MRI images of pyrazine at low concentration (120 mM) with large matrix (128x128 pixels) in as little as 78 ms is demonstrated at 500 MHz (11.7 T). We also recorded a time-series of images using a single bolus hyperpolarized pyrazine highlighting the feasibility of dynamic tracking. Here, the demonstrated approach allows recording MRI scans without transmit-receive electronics of the MRI scanner, which is highly desirable for portable MRI as well as the emerging field of hyperpolarized MRI using, e.g., HP protons, 129 Xe gas or HP 13 C labeled biomolecules as molecular tracers and imaging agents.

MRI

Multi-facility analysis using metered power data to quantify MRI energy use and utility bill costs across scanner operating modes

This study quantifies the energy consumption of magnetic resonance imaging (MRI) scanners across discrete operating modes during routine clinical workflows, based solely on electrical power measurements. Although previous studies have investigated MRI energy consumption within single hospitals or specific clinical settings, this research provides a broader and more systematic analysis. Researchers analyzed electrical power data and applied a previously developed semi-automatic method for identifying MRI operating modes using load duration curves for 20 MRI scanners across four different U.S. healthcare facilities, encompassing outpatient, inpatient, and mixed-use clinical settings. A key innovation is the inclusion of localized hourly utility rates to estimate costs, a parameter absent in prior literature. Key findings indicate significant variability in energy and cost profiles between weekdays and weekends. Scanner characteristics, including magnet strength, manufacturer, vintage, location, and clinical setting, influenced average daily energy consumption and power thresholds for operating modes. Notably, the clinical setting of a scanner predominantly determines its energy use. For example, the scanners in outpatient facilities consumed more energy. The breakdown of energy usage and costs by operating modes showed scanners spend between 61% and 93% of their time in nonproductive modes, with one outlier spending 34%. Average daily energy use for the scanners in the study ranged from 160 to 1069 kWh, with energy costs ranging from $\$$9 to $\$$149. This study uses an existing framework to quantify MRI energy behavior, leading to insights that can enable improved performance and cost savings across different healthcare environments.

24 POWER TRANSMISSION AND DISTRIBUTION

Ultra-low field 13 C MRI of hyperpolarized pyruvate

Medicine is evolving beyond therapy largely predicated on anatomical information and towards incorporating patient-specific molecular biomarkers of disease for more accurate diagnosis and effective treatment. The complementary combination of hyperpolarization by spin-lock induced crossing signal amplification by reversible exchange (SLIC SABRE) and low field magnetic resonance imaging (MRI) can enable accessible metabolic imaging to advance personalized medicine. Hyperpolarized 13 C-enriched pyruvate has demonstrated promise for imaging metabolism in cancer, heart disease and neurodegenerative disorders; however, broader clinical adoption awaits validated clinical indications, and is further constrained by the cost and limited availability of current hyperpolarization technology. Parahydrogen-based polarization techniques, paired with low-cost high-performance MRI at millitesla fields, offer a means of broadening the reach of metabolic imaging. Here we show results demonstrating in situ hyperpolarization of pyruvate at 6.5 mT by SLIC SABRE, followed by immediate readout without field cycling or sample shuttling. We achieve 13 C signal enhancements several million times above thermal equilibrium at 6.5 mT, corresponding to polarization levels of approximately 3%. Leveraging this enhancement, we perform 13 C MRI and acquire NMR spectra with resolution sufficient to distinguish chemical shifts between pyruvate isotopomers. These results show a viable pathway towards accessible metabolic imaging with hyperpolarized 13 C MRI at ultra-low field.

Medical and clinical diagnostics

Scalable Hyperpolarized MRI Enabled by Ace‐SABRE of [1‐ 13 C]Pyruvate

Abstract Hyperpolarized (HP) MRI using [1– 13 C]pyruvate is emerging as a promising molecular imaging approach. Among hyperpolarization methods, Signal Amplification By Reversible Exchange (SABRE) is attractive because SABRE polarizes the substrates directly in room‐temperature solutions avoiding complex hardware. Most SABRE experiments have historically been performed in methanol, a relatively toxic and difficult‐to‐remove solvent. Here we demonstrate the use of a 80/20 acetone/water (A/W) solvent system (Ace‐SABRE) to provide hyperpolarized [1– 13 C]pyruvate with up to 17% polarization, then implement a solvent processing protocol to achieve injectable solutions retaining 74% of the initial polarization, and lastly we demonstrate HP in vivo spectroscopy and imaging using the Ace‐SABRE platform to showcase metabolic tracking in a hepatocellular carcinoma (HCC) tumor as well as HP‐MRI, both in direct comparison to dissolution dynamic nuclear polarization (d‐DNP) experiments. The Ace‐SABRE technique promises faster adoption of SABRE hyperpolarization in biological experiments, overall lowering the barriers to entry for HP‐NMR and HP‐MRI.

Chemistry

Arm and shoulder muscle segmentation in axial MRI with UNet deep learning model

Quantifying individual upper-limb muscle volumes from MRI provides key insight into muscle-specific strength, deficits, and adaptations. Manual delineation is the gold standard but time‑intensive, and the performance of current deep learning approaches, particularly for small or anatomically complex muscles, remains incompletely characterized. We evaluated a state‑of‑the‑art deep learning framework across the entire upper limb and analyzed factors governing segmentation performance, with attention to the forearm. Three previously published MRI datasets (1.5 T, 3D GRE T1‑weighted; total n = 39) spanning young, middle‑aged, and older adults were curated and quality‑checked, including expert manual segmentations for 31 muscles. Following multiclass mask reconstruction, we trained three 3D nnU‑Net multiclass models matched to the muscle subsets present across datasets, using five‑fold cross‑validation and a composite Dice Similarity Coefficient (DSC) + cross entropy loss. Segmentation accuracy was assessed with DSC. Performance varied across muscles (mean DSC = 0.806 ± 0.098), ranging from 0.920 (Deltoid) to 0.461 (Extensor pollicis brevis). In uncertainty‑weighted regressions, muscle volume was positively associated with DSC (R2 = 0.36, p < 0.001), whereas training segmentation count and muscle orientation showed negligible associations (R2 ≤ 0.06). A weighted mixed‑effects model identified volume as the strongest evaluated predictor, explaining 23.9% of variance in DSC; orientation and training count each contributed <1%, leaving 61.5% unexplained. These results indicate that deep learning–based segmentation can accurately quantify muscle volume for many upper‑limb muscles but remains constrained for small, low‑contrast forearm muscles.

Gillespie, Samuel

Optimizing transmit field inhomogeneity of parallel RF transmit design in 7T MRI using deep learning

Ultrahigh field (UHF) Magnetic Resonance Imaging (MRI) provides a higher signal-to-noise ratio and, thereby, higher spatial resolution. However, UHF MRI introduces challenges such as transmit radiofrequency (RF) field (B+1) inhomogeneities, leading to uneven flip angles and image intensity anomalies. These issues can significantly degrade imaging quality and its medical applications. This study addresses B+1 field homogeneity through a novel deep learning-based strategy. Traditional methods like Magnitude Least Squares (MLS) optimization have been effective but are time-consuming and dependent on the patient’s presence. Recent machine learning approaches, such as RF Shim Prediction by Iteratively Projected Ridge Regression and deep learning frameworks, have shown promise but face limitations like extensive training times and oversimplified architectures. We propose a two-step deep learning strategy. First, we obtain the desired reference RF shimming weights from multi-channel B+1 fields using random-initialized Adaptive Moment Estimation. Then, we employ Residual Networks (ResNets) to train a model that maps B+1 fields to target RF shimming outputs. Our approach does not rely on pre-calculated reference optimizations for the testing process and efficiently learns residual functions. Comparative studies with traditional MLS optimization demonstrate our method’s advantages in terms of speed and accuracy. The proposed strategy achieves a faster and more efficient RF shimming design, significantly improving imaging quality at UHF. This advancement holds potential for broader applications in medical imaging and diagnostics.

Lu, Zhengyi [Vanderbilt University]

A Centralized AI Lakehouse Framework for Brain Tumor MRI Classification and Segmentation, University KPI Forecasting, and Water Potability Prediction

In many university and healthcare projects, models are built for very different data types such as tables, institutional time series, and medical images, but they are deployed as separate applications. In this work, that separation made testing and maintenance difficult because each module had its own pipeline and runtime requirements. This paper presents an integrated AI lakehouse-style implementation that runs three model pipelines inside one containerized backend. For medical imaging, we used MRI datasets from IEEE DataPort: a four-class classification set with 7012 images (5708 train/1304 test) and a segmentation set with 3063 image–mask pairs. The classification model (ResNet50 transfer learning) is evaluated using a proper train–validation–test protocol across multiple splits (80/10/10, 70/10/20, 60/10/30, and 10/30/60), achieving a test accuracy of 99.00% under the standard 80/10/10 split. Additionally, a patient-level evaluation is conducted using an external glioma dataset to provide a more realistic assessment without data leakage. The segmentation model (DeepLabV3-ResNet50) achieved 83.09% validation mIoU and 88.79% Dice score. For university KPI forecasting, we used annual IPEDS and NSF HERD data from 2010 to 2023 for three universities (BSU, EOU, and UAB). To examine the effect of preprocessing on forecasting performance, two case studies are conducted. In the first case, linear interpolation is applied to generate semester-level data. In the second case, the original annual data is used directly without interpolation. Random Forest regression and ARIMA models are evaluated using MAE, RMSE, MAPE, and R 2 . The results showed that interpolation improved apparent forecasting performance due to smoothing, while evaluation on the original annual data provided a more realistic assessment of model behavior. To further validate the framework on a larger dataset, an additional case study is conducted using a student dropout dataset. For water potability, we trained and compared multiple tabular classifiers on a large dataset (1,048,575 samples). A Random Forest model (100 trees, max depth 10) achieved 85.86% test accuracy and high recall for unsafe samples (0.8447). All modules are served via FastAPI and deployed together using Docker, with workflow automation routing requests to the correct endpoint. System-level benchmarking indicates that the backend maintains stable throughput and latency under concurrent requests.

97 MATHEMATICS AND COMPUTING

Fast-RF-Shimming: Accelerate RF shimming in 7T MRI using deep learning

Ultrahigh field (UHF) Magnetic Resonance Imaging (MRI) offers an elevated signal-to-noise ratio (SNR), enabling exceptionally high spatial resolution that benefits both clinical diagnostics and advanced research. However, the jump to higher fields introduces complications, particularly transmit radiofrequency (RF) field ($B^{+}_{1}$) inhomogeneities, manifesting as uneven flip angles and image intensity irregularities. These artifacts can degrade image quality and impede broader clinical adoption. Traditional RF shimming methods, such as Magnitude Least Squares (MLS) optimization, effectively mitigate $B^{+}_{1}$ inhomogeneity, but remain time-consuming. Recent machine learning approaches, including RF Shim Prediction by Iteratively Projected Ridge Regression and other deep learning architectures, suggest alternative pathways. Although these approaches show promise, challenges such as extensive training periods, limited network complexity, and practical data requirements persist. In this paper, we introduce a holistic learning-based framework called Fast-RF-Shimming, which achieves a 5000 ​× ​speed-up compared to the traditional MLS method. In the initial phase, we employ random-initialized Adaptive Moment Estimation (Adam) to derive the desired reference shimming weights from multi-channel $B^{+}_{1}$ fields. Next, we train a Residual Network (ResNet) to map $B^{+}_{1}$ fields directly to the ultimate RF shimming outputs, incorporating the confidence parameter into its loss function. Finally, we design Non-uniformity Field Detector (NFD), an optional post-processing step, to ensure the extreme non-uniform outcomes are identified. Comparative evaluations with standard MLS optimization underscore notable gains in both processing speed and predictive accuracy, which indicates that our technique shows a promising solution for addressing persistent inhomogeneity challenges.

Deep learning

PHASE: Personalized Head-based Automatic Simulation for Electromagnetic properties in 7T MRI

Accurate and individualized human head models are becoming increasingly important for electromagnetic (EM) simulations. These simulations depend on precise anatomical representations to realistically model electric and magnetic field distributions, particularly when evaluating Specific Absorption Rate (SAR) within safety guidelines. State of the art simulations use the Virtual Population due to limited public resources and the impracticality of manually annotating patient data at scale. Here, this paper introduces Personalized Head-based Automatic Simulation for EM properties (PHASE), an automated open-source toolbox that generates high-resolution, patient-specific head models for EM simulations using paired T1-weighted (T1w) magnetic resonance imaging (MRI) and computed tomography (CT) scans with 14 tissue labels. To evaluate the performance of PHASE models, we conduct semi-automated segmentation and EM simulations on 15 real human patients, serving as the gold standard reference. The PHASE model achieved comparable global SAR and localized SAR averaged over 10 grams of tissue (SAR-10g), demonstrating its potential as a promising tool for generating large-scale human model datasets in the future. The code and models of PHASE toolbox have been made publicly available: https://github.com/hrlblab/PHASE.

Deep learning

Using 3D Measurements from MRI to Improve VVUQ

Magnetic resonance velocimetry (MRV) is a diagnostic that can measure 3D, three-component turbulent velocity fields in arbitrarily complex flow configurations. The approach uses magnetic resonance imaging (MRI), which is a system commonly available in radiology departments or medical research centers. MRV acquires signal from hydrogen protons in water channel flows. Despite the obvious utility of the measurements for investigating a variety of flows, comparisons with computational fluid dynamic (CFD) simulations largely retain traditional metrics, comparing velocity profiles and planes at discrete regions within the flow rather than using the 3D nature of the measured field. In this effort, MRV was conducted in a simple water channel with six spanwise-centered periodic obstacles roughly shaped as cubes. At a fully turbulent Reynolds number of 15,000, the channel includes two flows: a main streamwise flow and, in the wake of the second obstacle, an injected flow oriented perpendicular to the streamwise flow. The flow geometry includes partial obstacles on the side walls and is inherently 3D because of the interaction of the two streams and the wake features, making the flow challenging to completely measure with traditional optical techniques. Aside from line profiles and planar comparisons, two 3D metrics are used to compare the data with a steady Reynolds-averaged Navier–Stokes (RANS) simulation result. A brief discussion about the comparison is provided, including comments about uncertainty.

Benson, Mike [ORNL] (ORCID:000000023210116X)

BrainXcan identifies brain features associated with behavioral and psychiatric traits using large-scale genetic and imaging data

Advances in brain MRI have enabled many discoveries in neuroscience. Case-control comparisons of brain MRI features have highlighted potential causes of psychiatric and behavioral disorders. However, due to the cost and difficulty of collecting MRI data, most studies have small sample sizes, limiting their reliability. Furthermore, reverse causality complicates interpretation because many observed brain differences are the result rather than the cause of the disease. Here we propose a method (BrainXcan) that leverages the power of large-scale genomewide association studies (GWAS) and reference brain MRI data to discover new mechanisms of disease etiology and validate existing ones. BrainXcan tests the association with genetic predictors of brain MRI-derived features and complex traits to pinpoint relevant brain-wide and region-specific features. Requiring only genetic data, BrainXcan allows us to test a host of hypotheses on mental illness, across many MRI modalities, using public data resources. For example, our method shows that reduced axonal density across the brain is associated with schizophrenia risk, consistent with the disconnectivity hypothesis. We also find that the hippocampus volume is associated with schizophrenia risk, highlighting the potential of our approach. Taken together, our results show the promise of BrainXcan to provide insights into the biology of GWAS traits.

Association study

Efficient and flexible multirate temporal adaptivity

In this work we present two new families of multirate time step adaptivity controllers, that are designed to work with embedded multirate infinitesimal (MRI) time integration methods for adapting time steps when solving problems with multiple time scales. We compare these controllers against competing approaches on two benchmark problems, showing that the proposed methods offer dramatically improved performance and flexibility. The combination of embedded MRI methods and the proposed controllers enable adaptive simulations of problems with a potentially arbitrary number of time scales, achieving high accuracy while maintaining low computational cost. Additionally, we introduce a new set of embeddings for the family of explicit multirate exponential Runge–Kutta (MERK) methods of orders 2 through 5, resulting in the first-ever fifth-order embedded MRI method. Finally, we compare the performance of a wide range of embedded MRI methods on our benchmark problems to provide guidance on how to select an appropriate MRI method and multirate controller.

97 MATHEMATICS AND COMPUTING

Reducing the Energy Consumption of Magnetic Resonance Imaging and Computed Tomography Scanners: Integrating Ecodesign and Sustainable Operations

This review aims to provide valuable insights into how energy consumption in magnetic resonance imaging (MRI) and computed tomography (CT) scanners can be effectively monitored, managed, and reduced, thereby contributing to more sustainable medical imaging practices. Demand for advanced imaging technologies such as MRI and CT scanners continues to increase, and understanding the resultant impact on greenhouse gas emissions requires a thorough evaluation of their energy consumption. Here, this review examines the energy monitoring and consumption characteristics of MRI and CT scanners, highlighting potential approaches for energy savings. An overview of MRI and CT principles, hardware components, and their associated energy consumption is provided. After addressing the technical aspects, the hardware and software requirements essential for accurate energy metering are detailed. Baseline measurements of energy consumption data are then provided as a foundation to understand current usage patterns and identify areas for improvement. Ongoing efforts to reduce energy consumption are categorized into 3 main strategies: operations, scanner design enhancements, and active scanning techniques, including accelerated MRI protocols. Ultimately, we emphasize that achieving sustainability in medical imaging requires collaboration across disciplines. By incorporating eco-friendly design in new imaging equipment, we can reduce the environmental impact, promote sustainability, and set a health care industry standard for a healthier planet.

62 RADIOLOGY AND NUCLEAR MEDICINE

Molecular-Level Insights into the NMR Relaxivity of Gadobutrol Using Quantum and Classical Molecular Simulations

MRI is an indispensable diagnostic tool in modern medicine; however, understanding the molecular-level processes governing NMR relaxation of water in the presence of MRI contrast agents remains a challenge, hindering the molecular-guided development of more effective contrast agents. By using quantum-based polarizable force fields, the first-of-its-kind molecular dynamics (MD) simulations of Gadobutrol are reported where the 1 H NMR longitudinal relaxivity r 1 of the aqueous phase is determined without any adjustable parameters. The MD simulations of r 1 dispersion (i.e., frequency dependence) show good agreement with measurements at frequencies of interest in clinical MRI. Importantly, the simulations reveal key insights into the molecular level processes leading to r 1 dispersion by decomposing the NMR dipole–dipole autocorrelation function G(t) into a discrete set of molecular modes, analogous to the eigenmodes of a quantum harmonic oscillator. The molecular modes reveal important aspects of the underlying mechanisms governing r 1 , such as its multiexponential nature and the importance of the second eigenmodal decay. By simply analyzing the MD trajectories on a parameter-free approach, the Gadobutrol simulations show that the outer-shell water contributes ∼50% of the total relaxivity r 1 compared to the inner-shell water, in contrast to simulations of (nonchelated) gadolinium-aqua where the outer shell contributes only ∼15% of r 1 . The deviation between simulations and measurements of r 1 below clinical MRI frequencies is used to determine the low-frequency electron-spin relaxation time for Gadobutrol, in good agreement with independent studies.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH

Nonideal stability analysis of differentially rotating plasmas with global curvature effects

The linear stability of global nonaxisymmetric modes in differentially rotating, magnetized, nonideal plasma is critical to classifying turbulence and transport phenomena. We investigate the competition between the local magneto-rotational instability (MRI) and the magneto-curvature instability (MCI)—a distinct nonaxisymmetric low-frequency curvature-driven global branch that appears alongside MRI. Here, to accomplish this, we developed a nonideal global spectral method, which is validated against NIMROD code simulations. This spectral approach allows for the direct derivation of an extended effective potential formalism and a resistive Alfvénic resonance condition, providing a framework for direct analysis of energy contributions and confinement mechanisms. Our study reveals that the global, low-frequency MCI persists at low magnetic Reynolds numbers (Rm), whereas the localized, high-frequency MRI is stabilized by diffusive broadening of its structure around its Alfvénic resonances. Consequently, we identify the global MCI branch as the primary onset mechanism for nonaxisymmetric magnetohydrodynamic instability in systems with finite curvature, e.g., astrophysical rotators. We establish distinct parameter regimes for mode dominance: MCI prevails in geometrically moderate-thickness disks with intermediate curvature and radial gaps, while MRI dominates in thin, low-curvature disks with large radial gaps. Mode competition is also highly sensitive to the flow profile, particularly vorticity and its gradient, with nonuniform shear profiles exhibiting more robust instability due to flow curvature (i.e., the second derivative of the flow profile) and shear contributions. A key outcome is the development of spectral diagrams derived from the global spectral method. These diagrams comprehensively map dominant instabilities and their characteristics, offering a predictive tool for critical onset parameters (i.e., flow curvature, magnetic field, and Rm) and facilitating the interpretation of experimental and simulation results. Notably, these diagrams demonstrate that the global MCI is generally the sole unstable mode at the initial onset of nonaxisymmetric instability.

Haywood, Alexander [Princeton Univ., NJ (United St

Signatures of a Tidally Induced Spiral Arm at the Anticenter of the Milky Way and a Kinematically Extended Anticenter Stream Using DESI Data Release 2

Using the Dark Energy Spectroscopic Instrument (DESI) Milky Way Survey, we examine the six-dimensional space of the anticenter region of the Milky Way stellar disk (150° < Galactic longitude < 220°) using 61,883 main-sequence turnoff stars. We focus on two well-known stellar overdensities in the anticenter: the Monoceros Ring (MRi) and Anticenter Stream (ACS). We find that the MRi overdensity has kinematic signatures consistent with a tidally induced spiral arm, a type of dynamic spiral arm created by an interaction with a satellite galaxy, most likely the Sagittarius dwarf spheroidal galaxy (Sgr). We use the kinematics of the MRi to calculate the two most recent passage times of Sgr, finding 0.25 ± 0.09 Gyr and 1.10 ± 0.23 Gyr from the present day. We validate that the ACS is kinematically decoupled from the MRi because they are moving in opposite radial and vertical directions. We find that the kinematics associated with the ACS extends beyond our defined overdensity. The features we see in the ACS region are likely part of a broader distribution of stars with the same kinematic signature as detected in other places, like the vertical wave in the outer disk and phase spiral.

Lambert, Mika [University of California, Santa Cru

High fidelity simulations of contaminant dispersion in an urban environment with comparison to magnetic resonance imaging measurements

The dispersion of a contaminant in an urban environment has the potential to impact a large population of people. In this work, a complex urban canopy flow based on the Oklahoma City downtown business district circa 2003 is studied using Magnetic Resonance Imaging (MRI) and high-fidelity Large Eddy Simulations (LES). MRI is a novel experimental technique that can provide high-resolution measurements in four dimensions (three spatial and temporal) for lab scale models. The experiments and simulations use the same geometry and boundary conditions providing a one-to-one comparison of the two methods. Results are presented on the time-averaged velocity and concentration fields, the temporal dynamics of the concentration plumes for a transient release, and a novel Cloud Identification Algorithm that can separate plumes produced by periodic contaminant releases used for ensemble averaging over many releases. The MRI and LES datasets both include millions of measurement voxels and the comparisons highlight the complex 3D nature of the flow including strong vertical velocities in spanwise street canyons and flow acceleration in streamwise street canyons. The concentration fields are qualitatively similar albeit the LES shows larger dispersion. A quantitative analysis with performance measures compares the datasets pointwise and demonstrates that the two 3D datasets are similar with respect to many measures including a fractional bias of 0.02 (ideal=0.0), correlation coefficient of 0.87 (ideal = 1.0), and the fraction points within a factor of 2 is 0.98 (ideal = 1.0). Plume analysis compares the arrival and residence time of contaminant and is found to vary significantly with location within the urban environment with arrival times between 0 and 1.25 and differences within the contaminant cloud less than 10% at most locations.

54 ENVIRONMENTAL SCIENCES

The POINTER Imaging baseline cohort: Associations between multimodal neuroimaging biomarkers, cardiovascular health, and cognition

Abstract INTRODUCTION The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) is evaluating lifestyle interventions in older adults at risk for cognitive decline and dementia. Here we characterize the baseline data set of the POINTER Imaging ancillary study. METHODS Participants underwent health and cognitive assessments and neuroimaging with multimodal positron emission tomography (PET) (beta‐amyloid [Aβ] and tau) and magnetic resonance imaging (MRI). Framingham risk score (FRS) was used to quantify cardiovascular disease (CVD) risk. RESULTS A total of 1052 participants (31% from underrepresented ethnoracial groups) were enrolled. Compared to Aβ−, Aβ+ (29%) participants were older, had higher apolipoprotein E (APOE) ε4 carriage rate and white matter hyperintensity volume, and greater temporal tau. FRS was related to MRI measures, but not AD biomarkers. FRS and tau had independent effects on cognition. DISCUSSION In this heterogenous, at‐risk cohort, CVD risk was related to more abnormal brain structure and poorer cognition, representing a putative non‐AD (Alzheimer's disease) pathway to brain injury and cognitive decline. Highlights The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) cohort is enriched for cardiovascular disease (CVD) and poor lifestyle POINTER Imaging collected multimodal neuroimaging data in this unique, at‐risk cohort Amyloid burden was related to age, apolipoprotein E (APOE) ε4 carriage, and measures of disease progression Associations between amyloid and tau, and tau and cognition, were relatively weak CVD risk and tau pathology were independently related to memory

Neurosciences & Neurology