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Table 8 Change in ADC between baseline and during NST; (i) percentage change, (ii) absolute change, (iii) ADC ratios baseline

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 After N cycles pCR versus non-pCR (mean ± SD%) ADC percentage change cutoff (%) AUC Sens (%) Spec (%) PPV (%) NPV (%)
(i) ΔADC %
Li [44] 1   6.5 0.63 50 78 55  
Pereira [18] 1 Overall: 44.36 ± 6.7 versus 7.54 ± 2.3 p =  < 0.001       
   TN: 53 versus 7 p = 0.002       
   Luminal B: 42 versus 16 p = 0.009       
   HER2-ov.exp: 43 versus 7 p = 0.055       
Zhang [24] 2 68.2 ± 49.6 versus 10.4 ± 26.3   0.877     
Partridge [23] 3 (= 3 weeks) Overall: 18 ± 20 versus 16 ± 21; p = 0.48   0.53     
   HR−/HER2−: 14 ± 15 versus 15 ± 18; p = 0.94   0.51     
   HR+/HER2−: 22 ± 18 versus 15 ± 22; p = 0.18   0.61     
   HR−/HER2+: 25 ± 26 versus 32 ± 28; p = 0.52   0.61     
   HR+/HER2+: 14 ± 23 versus 18 ± 23; p = 0.43   0.58     
Bedair [20] 3 49 versus 21 p = 0.03 → ADC       
   Other model based metrics:       
   45 versus 32 p = 0.04 → DDC       
   36 versus 23 p = 0.14 → D       
   − 29 versus 5 p = 0.05 → f       
   7 versus 5 p = 0.68 → α       
Fangberget [65]* 4 54.7 versus 18.5 p = 0.111       
Partridge [23] 12 (= 12 weeks) Overall: 50 ± 49 versus 36 ± 44; p = 0.017   0.60     
   HR−/HER2−: 33 ± 36 versus 26 ± 40; p = 0.33   0.57     
   HR+/HER2−: 75 ± 43 versus 35 ± 40; p < 0.001   0.76     
   HR−/HER2+: 63 ± 65 versus 35 ± 57; p = 0.40   0.67     
   HR+/HER2+: 40 ± 43 versus 56 ± 56; p = 0.53   0.56     
First author After N cycles pCR versus non-pCR (× 103 mm2/s)1 ADC change cutoff (× 103 mm2/s) AUC Sens (%) Spec (%) PPV (%) NPV (%)
(ii) ΔADC
Yuan [22]** 1   Luminal A2: 0.5589 0.845 87.3 73.4   
    Luminal B3: 0.5746 0.865 89.4 83.4   
    Basal-like4: 0.5854 0.879 89.9 82.6   
    HER2 enr.4: n.r. 0.783 n.r. n.r.   
Che [19]5 2 − 0.45 (− 0.67, − 0.29) versus 0.07 (− 0.16, − 0.01) p < 0.001 − 0.163 0.924 100 73.7 64.3 100
First author Time points pCR versus non-pCR6 ADC ratio cutoff (A.U.) AUC Sens (%) Spec (%) PPV (%) NPV (%)
(iii) ADC-ratio of two time points
Ramirez-Galván [25] 1 cycle/pre 1.08 ± 0.4 versus 1.12 ± 0.09 ≤ 1.09 0.641 85.9 58.6   
  2 cycles/pre 1.30 ± 0.28 versus 1.10 ± 0.10 > 1.14 0.807 79.2 79.7   
  3 cycles/pre 1.35 ± 0.28 versus 1.10 ± 0.15 > 1.08 0.826 100 66.7   
  Post/pre 1.49 ± 0.20 versus 1.13 ± 0.01 > 1.25 0.938 100 83.8   
  1. ADC apparent diffusion coefficient, AUC area under the curve, HER2-enr. human epidermal growth factor receptor 2 enriched, HR hormone receptor, pCR pathologic complete response, Sens sensitivity, Spec specificity, PPV positive predictive value, NPV negative predictive value, α intravoxel heterogeneity index, Δ representing change
  2. *31 MRI at pre NAC and after 4 cycles 27 MRI’s
  3. **Data in full-text was reported based on different NST (started with taxanes or anthracyclines, or taxanes and anthracyclines) and the molecular subtypes
  4. 1There has been chosen to use the exact numbers (positive and negative) in order to avoid misinterpretation, when definitions are not mentioned in the full-text
  5. Median and interquartile range in change in ADC for Che et al. [19]
  6. 2Compared after 1 cycle with anthracyclines
  7. 3Compared after 1 cycle of taxanes
  8. 4Compared after 1 cycle of anthracyclines and taxanes
  9. 5(Parameter-baseline)–(parameter after two cycles), change in true diffusion (D)
  10. 6Ratio: ADC time point after baseline/ADC baseline