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Insights into Imaging

Table 7 DWI parameters during 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

Cycle (s)

ADC-value (× 10−3 mm2/s)

pCR versus non-pCRa

Reported/chosen ADC threshold for pCR (× 10−3mm2/s)

ROC AUC

Sensitivity (%)

Specificity (%)

PPV (%)

NPV (%)

Tozaki [40]

1

0.55 versus 0.78 (range 0.45–0.95)

      

Li [44]

1

1.59 versus 1.24 p = 0.0019

1.4

0.82

83

67

59

 

Pereira [18]

1

1.214 ± 0.0599 versus 0.954 ± 0.0267

      

Che [19] (IVIM)

2

1.36 ± 0.30 versus 0.98 ± 0.23 p = 0.001

0.971

0.851

100 (66.4–100)

63.2 (38.4–83.7)

56.3 (30.6–79.3)

100 (69.9–99.2)

Zhang [24]

2

1.6 ± 0.4 versus 1.1 ± 0.3 p < 0.001

 

0.864

    

Kim [53]b

2

ADC: 1.23 (1.10–1.38) versus 1.36 (1.32–1.57)

1.29

0.70

0.79

0.62

  
  

D: 1.15 (1.10–1.34) versus 1.37 (1.25–1.60)

1.35

0.71

0.71

0.77

  

Minarikova [59]c

2c

1.33 ± 0.28 versus 1.13 ± 0.26

 

0.697d

    
 

3 & 4c

1.24 ± 0.15 versus 1.28 ± 0.30

 

0.500

    

Bedair [20]

3

1.52 ± 0.32 versus 1.27 ± 0.18 → ADC

      
  

Other model-based metrics:

      
  

1.51 ± 0.15 versus 1.40 ± 0.12 → DDC

      
  

1.30 ± 0.14 versus 1.28 ± 0.15 → D

      
  

0.91 ± 0.07 versus 0.86 ± 0.11 → α (a.u.)

      
  

8.48 ± 1.54 versus 10.53 ± 2.51 → f (%)

      

Fangberget [65]e

4

1.7 (range: 1.0–2.1) versus 1.2 (range: 0.9–1.7) or 1.3 p = 0.022f

1.42

 

88

80

  

Minarikova [59]c

5

1.10 ± 0.24 versus 1.34 ± 0.33

 

0.743

    
  1. ADC apparent diffusion coefficient, D true diffusivity, DDC distributed diffusion coefficient, f perfusion fraction, NPV negative predictive value, PPV positive predictive value, pCR pathologic complete response, ROC AUC area under the receiver operating characteristic curve, TN triple negative, α intravoxel heterogeneity index
  2. aMean ADC-value ± SD with the exception of Li et al. [44]: median ADC
  3. bMiller and Payne grade 4 included as good responders
  4. cAfter 2 cycles: 14 lesions; after 3–4 cycles: 19 lesions and 5 cycles: 34 lesions scanned
  5. dAbout the data (ADC) and ROC-analysis: “smaller values were considered positive for pCR prediction in BS, after three to four cycles and after five to eight cycle; however, higher values were considered positive for pCR prediction in data measured after two cycles” [59]
  6. e31 MRI at pre NAC and after 4 cycles 27 MRI’s
  7. f1.2 × 10−3 mm2/s and 1.3 × 10−3 mm2/s for non-pCR mentioned in [65]
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