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Table 4 Diagnostic performance of dedicated vs. standard protocol

From: The role of MRI in axillary lymph node imaging in breast cancer patients: a systematic review

First author, year   Sensitivity (95 % CI) Specificity (95 % CI) NPV (95 % CI) PPV (95 % CI) Accuracy (95 % CI)
Dedicated to axilla
T1w/T2w/DCE
  Yoshimura et al. 1999   79.0 % 93.0 % 87.0 % 89.0 % 88.0 %
  Kvistad et al. 2000   83.0 % 90.0 % 90.0 % 83.0 % 88.0 %
  Li et al. 2014   94.6 % 98.5 % 95.0 % 98.2 % Not reported
  Median 88.4 % 93.0 % 94.7 % 89.0 % 86.5 %
  Range 79–94.6 % 90–98.5 % 87–95 % 83.0–98.2 % 88.0 %
T2*w USPIO
  Michel et al. 2002 Disease based 82.0 % 100 % 78.0 % 100,0 % 89.0 %
Two readers lymph node based 73.083.0 % 96.097.0 % 97.098.0 % 71.074.0 % 94.095.0 %
  Harada et al. 2006 Combined study 86.4 % 97.5 % 96.1 % 91.1 % 95.0 %
Postcontrast alone 84.7 % 96.8 % 95.6 % 88.5 % 94.0 %
  Median 83.0 % 97.0 % 95.9 % 89.8 % 94.3 %
Range 73.0–86.4 % 96.0–100 % 78.0–98.0 % 71.0–100 % 89.0–95.0 %
  Median 84.7 % 96.8 % 95.0 % 89.0 % 91.5 %
Range 73–94.6 % 90.0–100.0 % 78.0–98.0 % 71.0–100 % 88.0–95.0 %
Covering breast and axilla
T1w/T2w/DCE
  Orguc et al. 2012   89.0 % 14.0 % 80.0 %* 21.4 %* Not reported
  He et al. 2012 Overall 33.386.5 % 95.298.2 % 1.916.7 % 66.782.6 % Not reported
Early stage enhancement rate** 97.0 % 73.5 % 99.5 %* 30.5 %* Not reported
  Scaranelo et al. 2012   88.4 % (76–95) 82.4 % (71–90) 94.7 %* 69.4 %* 85.0 % (77–91)
  Hwang et al. 2013   47.8 % 88.7 % 82.6 % 60.2 % 77.9 %
  Hieken et al. 2013 N0 with N0i+ 54.2 % (46.661.6) 78.2 % (73.282.5) 75.7 % (70.780.1) 57.7 % (49.965.2) 69.7 %
N0 without N0i+ 57.2 % (49.164.9) 78.2 % (73.282.5) 78.9 % (74.083.2) 56.2 % (48.263.9) 71.3 %
  Abe et al. 2013   60.0 % 79.0 % 81.0 % 59.0 % 74.0 %
  An et al. 2014   67.5 % 78.0 % 79.2 % 65.9 % 74.0 %
  Median 60.0 % 78.6 % 80.0 % 59.0 % 74.0 %
Range 33.3–97.0 % 14.0–98.5 % 1.9–99.5 % 21.4–92.6 % 69.7–85.0 %
DWI
  Fornasa et al. 2012 Cutoff <1.09 × 10−3 mm2/s 94.7 % 91.7 % 95.7 % 90.0 % 93.0 %
  He et al. 2012 Cutoff <1.35 × 10−3 mm2/s 97.0 % 54.5 % 99.4 %* 20.4 %* Not reported
  Scaranelo et al. 2012 No cutoff value 83.9 % (73–91) 77.0 % (65–86) 90.9 %* 60.5 %* 80.0 % (72–86)
  Luo et al. 2013 Cutoff <0.89 × 10−3 mm2/s 82.2 % 82.4 % 77.8 % 86.1 % 82.3 %
ADC ratio*** ≤1.097 84.4 % 88.2 % 81.1 % 90.5 % 86.1 %
  Kamitani et al. 2013 Cutoff <1.05 × 10−3 mm2/s 53.8 % 86.9 % 85.9 % 56.0 % 79.1 %
Cutoff <1.22 × 10−3 mm2/s 75.6 % 71.1 % 90.2 % 54.3 % Not reported
  Basara et al. 2013 Cutoff <1.49 × 10−3 mm2/s 95.6 % 30.3 % 95.6 % 30.3 % Not reported
  Median 84.2 % 79.7 % 90.6 % 58.3 % 82.3 %
Range 53.8–97.0 % 30.3–91.7 % 77.8–99.4 % 20.4–90.5 % 79.1–93.0 %
  Median 82.0 % 78.2 % 82.6 % 59.0 % 79.1 %
Range 33.3–97.0 % 14.0–98.5 % 1.9–95.7 % 30.3–92.6 % 69.7–93.0 %
  1. T1w T1 weighted, T2w T2 weighted, T2*w T2* weighted, N+ nodal stage positive, N0 no regional lymph node metastasis, N0i + isolated tumour cells, DCE dynamic contrast enhanced, DWI diffusion-weighted imaging, T2*w T2* weighted, USPIO ultrasmall superparamagnetic iron oxide, ADC apparent diffusion coefficient, CI confidence interval
  2. *Calculated parameters, **diagnostic parameter with a combination of the highest senstivity and NPV, ***ADC ratio = ratio of lymph node ADC value to the primary tumour ADC value