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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]