Original Research Role of elasticity imaging/B-mode imaging ratio in the evaluation of solid breast lesions

Asif I. Tamboli, Abhijit A. Gadpalliwar, Raghav Agarwal, Chaitali V. Ukirade

South African Journal of Radiology | Vol 29, No 1 | a3158 | DOI: https://doi.org/10.4102/sajr.v29i1.3158 | © 2025 Asif I. Tamboli, Abhijit A. Gadpalliwar, Raghav Agarwal, Chaitali V. Ukirade | This work is licensed under CC Attribution 4.0
Submitted: 26 March 2025 | Published: 23 July 2025

About the author(s) Asif I. Tamboli, Department of Radiodiagnosis, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth, Karad, India
Abhijit A. Gadpalliwar, Department of Radiodiagnosis, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth, Karad, India
Raghav Agarwal, Department of Radiodiagnosis, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth, Karad, India
Chaitali V. Ukirade, Department of Radiodiagnosis, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth, Karad, India

Abstract

Background: Ultrasound elastography, with the measurement of the lesional width ratio between elasticity imaging (EI) and B-mode image (BI) (EI/BI), provides a non-invasive method for breast cancer (BC) characterisation. Evidence from a limited number of researchers supporting the efficacy of this ratio in avoiding unnecessary biopsies warrants further exploration.

Objectives: To assess the role of the EI/BI ratio in the evaluation of solid breast lesions and correlate the findings with histopathological results.

Method: The study enrolled 54 female patients with clinically palpable breast lesions, non-palpable breast lesions (seen on mammography or ultrasound) and high-risk female participants with a positive family history of BC. Using ultrasound elastography, the EI/BI ratio was calculated and correlated with the histology using the Chi-square test and Cramer’s V test.

Results: The mean age was 41.9 ± 11.8 years, and 59.2% had fibroadenomas. The EI/BI ratio was ≥ 1 in 16 (29.6%) cases, where malignancy was confirmed on histology in all cases. Thirty-eight cases were benign as per the EI/BI ratio (< 1), of which 2 were found to be malignant. A significant correlation was seen between the EI/BI ratio and histopathology findings (p < 0.001). The specificity, sensitivity, positive and negative predictive values and diagnostic accuracy of the EI/BI ratio were 100%, 88.9%, 94.7%, 100% and 96.3%, respectively.

Conclusion: The EI/BI ratio is effective in differentiating between benign and malignant solid breast lesions, with a statistically significant correlation with histopathology.

Contribution: The study validates the use of EI/BI ratio by radiologists to effectively differentiate between benign and malignant breast lesions in patients.

Keywords

breast neoplasm; elasticity imaging techniques; ultrasound elastography; histopathology; EI/BI ratio

Sustainable Development Goal

Goal 15: Life on land

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