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Table 6 DWI parameters pre-NST

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 ADC-value (× 10−3 mm2/s)
pCR versus non-pCRa
Reported/chosen ADC threshold for pCR (× 10−3 mm2/s) ROC AUC (95% CI) Sensitivity (%) Specificity (%) PPV (%) NPV (%)
Minarikova [59] 0.87 ± 0.12 versus 0.96 ± 0.23 p = 0.287   0.633     
Shin [26] 0.83 (0.77, 0.87) versus 0.97 (0.82, 1.10) p = 0.014 0.92 0.75 (0.58, 0.88) 82 65   
Fangberget [65]b 1.1 versus 1.1 p = 0.693   0.80     
Woodhams [64]c pCR as in full-text (excl. DCIS)   0.55     
  0.81 ± 0.15 versus 0.85 ± 0.19 p = 0.64   0.52     
  pCR incl. DCIS: 0.85 ± 0.18 versus 0.85 ± 0.19 p = 0.82       
Bufi [17]d Overall: 1.132 versus 1.092 p = 0.23 Overall: 0.975 Overall: 0.587     
  Luminal: 1.157 versus 1.077 p = 0.59 Luminal: 0.832 Luminal: 0.588     
  Hybrid: 1.036 versus 1.079 p = 0.53 Hybrid: 0.959 Hybrid: 0.567     
  TN: 1.034 versus 1.114 p = 0.06 TN: 0.995 TN: 0.766     
  HER2+: 1.101 versus 1.232 p = 0.05 HER2+: 0.971 HER2+: 0.813     
Pereira [18] Overall: 0.832 ± 0.198 versus 0.853 ± 0.171 p = 0.882       
  Luminal B: 0.755 (0.596–1.035) versus 0.802 (0.483–1.090) p = 0.359       
  TN: 0.857 (0.448–1.330) versus 1.02 (0.739–1.390) p = 0.070       
  HER2: 0.826 (0.651–1.140) versus 0.847 (0.772–0.949) p = 0.522       
Santamaria [27] 1.025 ± 0.153 versus 1.072 ± 0.231 p = 0.549       
Li [44]   1.22 0.72 93 52 50  
Tozaki [40]e 0.41 versus 0.64 (range 0.46–0.83) 0.45 100 100   
Che [19]f (IVIM- > D) 0.92 (0.77, 0.95) versus 0.83 (0.75, 0.92) p = 0.323 0.874 0.600 (0.424–0.759) 69.2 (38.6–90.9) 65.2 (42.7–83.6) 52.9 (28.5–76.1) 78.9 (53.9–93.0)
Kim [53]g 1.13 (1.01–1.25) versus 1.23 (1.12–1.41) → ADC       
  1.10 (1.01–1.22) versus 1.22 (1.10–1.49) → D       
Yuan [22]    Luminal A: 0.556     
    Luminal B: 0.538     
    Basal-like: 0.534     
    HER2-Enr.: 0.601     
Partridge [23] 1.08 ± 0.16 versus 1.08 ± 0.22       
Liu [16] Luminal A: 1.01 ± 0.12 versus 1.06 ± 0.07 p = 0.293       
  Luminal B: 1.01 ± 0.16 versus 1.07 ± 0.08 p = 0.070       
  HER2-enriched: 1.05 ± 0.11 versus 1.14 ± 0.07 p = 0.098       
  Triple-negative: 1.04 ± 0.08 versus 1.22 ± 0.08 p < 0.001       
Bedair [20] 0.92 ± 0.03 versus 1.20 ± 0.02 p < 0.01 → ADC 1.012 0.749 81 67   
  0.93 ± 0.04 versus 1.25 ± 0.03 p < 0.01 → DDC 1.141 0.756 81 72   
  0.85 ± 0.05 versus 1.02 ± 0.05 p = 0.02 → D 0.838 0.644 60 47   
  Other model based measures: 0.81 ± 0.02 versus 0.84 ± 0.02 p = 0.07 → α (a.u.) 0.967 0.641 71 53   
Zhang [24] 1 ± 0.2 versus 1 ± 0.2 p = 0.645       
  1. ADC apparent diffusion coefficient, CI confidence interval, D true diffusivity, DCIS ductal carcinoma in situ, DDC distributed diffusion coefficient, HER2 human epidermal growth factor receptor 2, f perfusion fraction, ROC AUC area under the receiver operating characteristic curve, NPV negative predictive value, pCR pathologic complete response, PPV positive predictive value, TN triple negative
  2. aMean ADC-value ± SD with the exception of Che et al. [19]: median ADC and the interquartile range
  3. b31 MRI at pre NAC and after 4 cycles 27 MRI’s
  4. cMean and SD calculated by data extraction within the supplementary material, rounded by two decimals, p value calculated with independent samples Mann–Whitney U test, and AUC-ROC in SPSS
  5. dHybrid tumors: luminal tumors with HER2+; TN: triple negative; data from the HER2+ group represents the HER2-enriched tumors in this case
  6. eThreshold can be chosen based on ADC-value of the pCR case, resulting in 100% sensitivity and specificity
  7. fD is the true diffusion coefficient in IVIM
  8. gMiller and Payne grade 4 included as good responders