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Table 5 Main region-of-interest specifications

From: Factors affecting the value of diffusion-weighted imaging for identifying breast cancer patients with pathological complete response on neoadjuvant systemic therapy: a systematic review

First author 2D/3D Nr. (one/multiple)1 Predefined absolute size? Excluding areas2 Only highest signal (b-image)/lowest on ADC map/solid part tumor3 ROI no residual disease post-NST visible
Santamaria [27]4 2D: circular Three (diff. sections) Y: (≤ 15 mm2) Y Not specified Pretreatment location
Tozaki [40] 2D: circular One Y 19.6 mm2 (r = 2.5 mm) n.r. Y n.r.
Bufi [17]       
 – Before 2D One No Y No N/A
 – Post5  
Che [19] 2D One No: based on max transverse diameter Y Different description n.r.
Fangberget [65] Not spec. One (solid part) No Y Y n.r.
Minarikova [59]6 3D One No: region growing (upper & lower bounds) Not specified (in 3D) No n.r.
Woodhams [64]7 2D Pre: two to seven No Not specified No n.r.
Post: one to seven
Shin [26] 3D One No Y No No residual enhancement: images compared pre and post-NAC, incl. cardiac level and the surrounding
Hahn [67] 2D Three (slices) No (based on the largest cross-sectional planes → three slides) Y (especially fat and normal parenchyma, further not specified) No n.r.
Yuan [22] 3D One No Y No n.r.
Partridge [23] 3D One composite No Y No Region at previous scan with visible tumor
Gallivanone [21] 3D One No (semi-automatic method: see Gallivanone et al.) Y Not only (see details Gallivanone et al.) n.r.
Li [44] 3D One No (copied from the DCE-ROI tumor8) n.r. Different description n.r.
Fujimoto [66] 2D One No (based on largest diameter) Y Different description Pre-treatment ROI
Liu [16] 2D (pseudo- 3D) Three No (based on largest cross-sectional area’s) n.r. Different description Pre-treatment ROI
Bedair [20] 2D One No Y No: largest tumor dimension on b = 900 n.r.
Ramirez-Galván [25] 2D Three No (three ellipses randomly placed) Y No ?
Pereira [18] 2D One n.r. Y Y n.r.
Zhang [24] 2D Three types: n.r. Y Different description n.r.
(a) Freehand
(b) Single-round
(c) Three-round
Kim [53] 2D (manual) → 3D (automatic) Three (sagittal, coronal, axial) No Y Different (on b = 0, based on DCE and T2) n.r.
  1. ADC apparent diffusion coefficient, n.r. not reported, r radius, ROI region of interest
  2. 1Short description
  3. 2Not specified for which areas (but referring to areas such as inner margins, necrotic, fibrotic areas etc.)
  4. 3No: the ROI was not limited to solid or other tumor part on the slice or high signal on b-image, respectively, low signal on ADC
  5. 4Multiple ROI methods, but this refers to mean value method used for data analysis, the reported area could be for all three together or each area
  6. 5Situation depended: delineation on b = 1000 s/mm2, in case of tumor fragmentation ROI including not hyperintense “interspersed” area and the whole lesion, otherwise in case of no clear region, ROI of 100 pixels within the previous observed area
  7. 62D and 3D ROI’s: 3D-ROI’s in majority used for comparisons-not applicable: referring to a different image property
  8. 7The ADC of the multiple ROI’s were averaged and mean ROI-size was pre-NST 37 ± 17 mm and post-NST 20 ± 15 mm
  9. 8At least 80% percent signal intensity increase after contrast injection, see further Li et al. [44] Pseudo 3D: several slices, but not whole lesion in 3D