Table 1. Characteristics of the included study subsets grouped per breast tumor tissue selection (BTTS) method.
| BTTS 1: Whole tumor tissue selection: | ||||||||||||
| Author + year | Reference | Number of lesions | Number of malignant lesions | Number of benign lesions | Field strength (Tesla) | Slice thickness (mm) | DWI pre/post contrast | Image of BTTS drawing | b-values used for ADC calculation (s/mm2) | ADC threshold (10−3 mm2/s) | Sensitivity | Specificity |
| Bougias 2017 | [42] | 53 | 34 | 19 | 1.5 | 4 | Pre | DWI, copied to ADCmap | 0, 1300 | 1.150 | 0.97 | 0.95 |
| Hirano 2012 (1) | [35] | 75 | 48 | 27 | 3.0 | 3 | Pre | ADCmap | 50, 800, 1500 | 0.980 | 0.85 | 0.85 |
| Jin 2010 | [39] | 60 | 40 | 20 | 1.5 | 4 | Pre | DWI | 0, 1000 | 1.180 | 0.77 | 0.95 |
| Li 2019 | [43] | 120 | 62 | 58 | 3.0 | 5 | Pre | DWI | 0, 1000 | 1.091 | 0.63 | 0.90 |
| Satake 2011 | [40] | 115 | 88 | 27 | 3.0 | 3 | Pre | ADCmap, with reference to DCE | 50, 1500 | 0.910 | 0.69 | 0.70 |
| Song 2017 | [41] | 131 | 106 | 25 | 3.0 | 3 | Pre | ADCmap | 0, 1000 | 1.110 | 0.87 | 0.68 |
| Woodhams 2005 | [38] | 191 | 167 | 24 | 1.5 | 6 | Pre | ADCmap, with reference to DCE | 0, 750, 1000 | 1.600 | 0.93 | 0.46 |
| BTTS 2: Subtracted whole breast tumor tissue selection: | ||||||||||||
| Aribal 2016 | [49] | 138 | 75 | 63 | 1.5 | 3 | Pre | ADCmap, with reference to DCE | 50, 800 | 1.118 | 0.91 | 0.83 |
| Arponen 2015 (1) | [16] | 137 | 114 | 23 | 3.0 | 4 | Post | ADCmap | 0, 200, 400, 600, 800 | 0.870 | 0.93 | 0.78 |
| Arponen 2016 | [47] | 29 | 14 | 15 | 3.0 | 4 | Post | ADCmap | 0, 200, 400, 600, 800 | 0.870 | 0.93 | 0.80 |
| Bogner 2009 | [20] | 61 | 24 | 17 | 3.0 | 3.5 | Pre | DWI, with reference to DCE + T2 | 50, 850 | 1.250 | 0.96 | 0.94 |
| Bogner 2012 | [17] | 49 | 28 | 21 | 3.0 | 5 | Pre | ADCmap, with reference to DWI, DCE | 0, 850 | 1.250 | 0.89 | 0.90 |
| Chen 2018 | [55] | 116 | 72 | 44 | 3.0 | 5.5 | Post | DCE, copied to ADCmap | 50, 800 | 1.240 | 0.76 | 0.62 |
| Fanariotis 2018 | [23] | 62 | 27 | 35 | 3.0 | 4 | Pre and Post | DWI, with reference to DCE | 0, 1000 | 1.100 | 0.93 | 0.89 |
| Gity 2018 (1) | [37] | 98 | 50 | 48 | 1.5 | 5 | Post | ADCmap | 0, 800 | 1.450 | 0.92 | 0.74 |
| Gruber 2016 | [46] | 28 | 18 | 10 | 3.0 | 5 | NA | DWI, with reference to ADCmap | 0, 850 | 1.257 | 0.94 | 0.90 |
| Guo 2002 | [56] | 47 | 30 | 17 | 1.5 | 5 | Pre | DWI/ADC | 0, 250, 500, 750, 1000 AND 0, 1000 | 1.300 | 0.93 | 0.88 |
| Iima 2015 | [53] | 23 | 15 | 8 | 3.0 | 3 | Pre | DWI, with reference to T2 | 0, 1000 | 1.400 | 1.00 | 0.88 |
| Inoue 2011 | [57] | 106 | 91 | 15 | 1.5 | 8 | Pre | ADCmap | 0, 250, 500, 750, 1000 | 1.290 | 0.95 | 0.80 |
| Liu 2013 | [52] | 111 | 40 | 41 | 1.5 | 5 | Pre | ADCmap, with reference to MRI (incl. DCE) | 0, 1000 | 1.180 | 0.93 | 0.90 |
| Moschetta 2014 | [44] | 128 | 77 | 51 | 1.5 | 3 | Pre | DWI | 0, 1000 | 1.440 | 0.97 | 0.83 |
| Pinker 2013 | [58] | 294 | 209 | 85 | 3.0 | 3.5 | Pre | ADCmap, with reference to DWI, DCE, MRI | 50, 850 | 1.275 | 0.92 | 0.89 |
| Pinker 2014 | [54] | 76 | 53 | 23 | 3.0 | 3.5 | Pre | ADCmap, with reference to DWI, DCE | 50, 850 | 1.250 | 0.96 | 0.96 |
| Rubesova 2006 | [15] | 87 | 65 | 22 | 1.5 | 4 | Post | ADCmap, with reference to DCE | 0, 200, 400, 600, 1000 | 1.150 | 0.85 | 0.86 |
| Si 2016 | [48] | 57 | 28 | 29 | 3.0 | 4 | Pre | ADCmap, with reference to DCE | 0, 800 | 1.190 | 0.71 | 0.86 |
| Sun 2015 | [51] | 98 | 57 | 41 | 1.5 | 4 | Pre | ADCmap, with reference to DWI, DCE | 50, 1000 | 0.895 | 0.86 | 0.83 |
| Suo 2017 | [50] | 101 | 57 | 44 | 3.0 | 3 | Pre | DWI, with reference to MRI | 0, 10, 30, 50, 100, 150, 200, 500, 800, 1000, 1500, 2000, 2500 | 0.870 | 0.93 | 0.75 |
| Wan 2016 | [45] | 95 | 74 | 21 | 1.5 | NA | Pre | DCE, copied to ADCmap | 0, 1000 | 1.088 | 0.86 | 0.78 |
| Zhang 2015 (1) | [36] | 248 | 163 | 85 | 1.5 | 6 | Pre | ADCmap, with reference to DCE, T2, T1 | 0, 800 | 1.223 | 0.85 | 0.92 |
| BTTS 3: Circular breast tumor tissue selection: | ||||||||||||
| Abd El-Aleem 2018 | [64] | 44 | 25 | 19 | 1.5 | 3.5 | Pre | ADCmap | 0, 200, 400, 600, 800 | 1.260 | 0.88 | 0.95 |
| Altay 2014 | [62] | 37 | 23 | 14 | 1.5 | 5 | Pre | ADCmap, with reference to MRI | 0, 1000 | 1.100 | 0.90 | 0.86 |
| Cabuk 2015 | [66] | 63 | 22 | 41 | 1.5 | 4 | Post | ADCmap | 0, 1000 | .980 | 0.86 | 0.81 |
| Cakir 2013 | [21] | 55 | 30 | 25 | 3.0 | 2.5 | Pre | ADCmap/DWI with reference to DCE | 0, 1500 | 1.120 | 0.97 | 0.60 |
| Fornasa 2011 | [24] | 78 | 35 | 43 | 1.5 | 7 | NA | DWI | 0, 800 | 1.480 | 0.89 | 0.95 |
| Hatakenaka 2008 | [68] | 140 | 124 | 16 | 1.5 | NA | Pre | ADCmap, with reference to MRI | 0, 500, 1000 | 1.480 | 0.84 | 0.81 |
| Ibrahim 2015 | [59] | 40 | 18 | 22 | 1.5 | 3 | Post | ADCmap, with reference to MRI | 0, 400, 800 | 1.250 | 1.00 | 0.77 |
| Kothari 2017 | [61] | 88 | 65 | 23 | 3.0 | 4 | Pre | DWI | 0, 800 | 1.100 | 0.92 | 0.74 |
| Lo 2009 | [69] | 31 | 20 | 11 | 3.0 | 6 | Pre | ADCmap, with reference to DCE, DWI | 0, 1000 | 1.210 | 0.90 | 0.91 |
| Marini 2007 | [25] | 81 | 42 | 39 | 1.5 | 4 | Pre | ADCmap | 0, 1000 | 1.100 | 0.80 | 0.81 |
| Ozgokce 2019 | [67] | 51 | 23 | 28 | 1.5 | NA | NA | ADCmap | 0, 200, 400, 600, 800, 1000 | 1.100 | 0.91 | 0.96 |
| Pereira 2009 | [19] | 52 | 26 | 26 | 1.5 | 5 | Post | ADCmap, with reference to MRI | 0, 250, 500, 750, 1000 | 1.210 | 0.92 | 0.92 |
| Sahin 2013 | [71] | 51 | 35 | 16 | 1.5 | 3.5 | Pre | ADCmap, with reference to DCE + T2 | 50, 800 | 1.030 | 0.89 | 1.00 |
| Sharma 2016 | [60] | 326 | 259 | 67 | 1.5 | NA | Post | ADCmap | 0, 500, 1000 | 1.123 | 0.93 | 0.91 |
| Sonmez 2011 | [70] | 45 | 25 | 20 | 1.5 | 5 | Pre | ADCmap, with reference to DCE | 0, 50, 200, 500, 1000 | 1.000 | 0.96 | 1.00 |
| Tan 2014 | [65] | 44 | 31 | 13 | 3.0 | NA | Pre | DWI, with reference to DCE | 0, 1000 | 1.220 | 0.91 | 0.92 |
| Yili 2009 | [18] | 57 | 35 | 22 | 1.5 | 5 | Pre | ADCmap | 0, 1000 | 1.200 | 0.96 | 0.97 |
| Zhang 2015 (2) | [36] | 248 | 163 | 85 | 1.5 | NA | Pre | ADCmap, with reference to DCE, T2, T1 | 0, 800 | 1.315 | 0.90 | 0.89 |
| Zhao 2016 | [63] | 48 | 25 | 23 | 3.0 | 4 | Pre | DWI, with reference to DCE | 0, 1000 | 1.350 | 0.68 | 0.96 |
| BTTS 4: Lowest diffusion breast tumor tissue selection: | ||||||||||||
| Author + year | Reference | Number of lesions | Number of malignant lesions | Number of benign lesions | Field strength (Tesla) | Slice thickness (mm) | DWI pre/post contrast | Image of BBTS drawing | b-values used for ADC calculation (s/mm2) | ADC threshold (10−3 mm2/s) | Sensitivity | Specificity |
| Arponen 2015 (2) | [16] | 137 | 114 | 23 | 3.0 | NA | Post | ADCmap | 0, 200, 400, 600, 800 | 0.690 | 0.96 | 0.70 |
| Baltzer 2009 | [28] | 74 | 39 | 35 | 1.5 | 6 | Post | DWI, copied to ADCmap | 0, 750, 1000 | 1.233 | 0.87 | 0.83 |
| Baltzer 2010 | [79] | 81 | 54 | 27 | 1.5 | 6 | Post | ADCmap | 0, 750, 1000 | 1.230 | 0.91 | 0.76 |
| Cheng 2013 | [26] | 127 | 86 | 41 | 1.5 | 4 | Pre | DWI, with reference to DCE | 0, 1000 | 1.050 | 0.70 | 0.85 |
| Gity 2018 (2) | [37] | 98 | 50 | 48 | 1.5 | 5 | Post | ADCmap | 0, 800 | 1.450 | 0.92 | 0.74 |
| Hirano 2012 (2) | [35] | 75 | 48 | 27 | 3.0 | NA | Pre | ADCmap | 50, 800, 1500 | 0.840 | 0.75 | 0.74 |
| Khattab 2018 | [77] | 26 | 15 | 11 | 1.5 | 5 | Post | DWI | 0, 1000 | 1.240 | 0.87 | 0.82 |
| Kul 2011 | [72] | 84 | 47 | 37 | 1.5 | 3 | Pre | ADCmap | 50, 1000 | 0.920 | 0.91 | 0.86 |
| Kul 2014 | [27] | 285 | 124 | 161 | 1.5 | 3 | Pre | DWI, with reference to DCE | 50, 400, 1000 | 0.900 | 0.95 | 0.80 |
| Kul 2018 | [74] | 203 | 143 | 70 | 1.5 | 3 or 4 | Pre | ADCmap | 50, 400, 1000 or 0, 500, 1000 | 0.960 | 0.91 | 0.90 |
| Liu 2018 | [75] | 150 | 77 | 73 | 1.5 | 4 | Pre | ADCmap | 0, 800 | 1.080 | 0.83 | 0.80 |
| Nogueira 2014 | [22] | 157 | 89 | 68 | 3.0 | 5 | Pre | DWI, with reference to DCE | 50, 200, 400, 600, 800, 1000 | 1.470 | 0.78 | 0.85 |
| Ohlmeyer 2019 | [78] | 72 | 46 | 26 | 3.0 | 2.5 | Post | DWI, with reference to DCE | 50, 800 | 1.230 | 1.00 | 0.92 |
| Ouyang 2014 | [8] | 39 | 23 | 16 | 3.0 | 4 | Pre | ADCmap, with reference to T2 (necrosis) | 0, 800 | 1.230 | 0.87 | 0.88 |
| Polat 2013 | [73] | 61 | 26 | 35 | 1.5 | 5 | Pre | ADCmap, with reference to DCE + T2 | 50, 400, 800 | 1.220 | 0.96 | 0.89 |
| Spick 2014 | [3] | 61 | 15 | 46 | 1.5 | NA | Pre | ADCmap | 50, 400, 800 | 1.580 | 0.95 | 0.82 |
| Yilmaz 2018 | [76] | 88 | 34 | 54 | 1.5 | 4.5 | Post | DCE, copied to ADCmap | 0, 1000 | 1.040 | 0.88 | 0.87 |
NA = not applicable, ADC = Apparent diffusion coefficient, DWI = diffusion weighted imaging, DCE = dynamic contrast enhanced, BTTS = breast tumor tissue selection and (1)/(2) refers to two different BTTS method inclusions (study subsets) from the same study.