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

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

PMC · DOI: 10.4102/sajr.v29i1.3158 · SA Journal of Radiology · 2025-07-23

## TL;DR

This study shows that the EI/BI ratio in ultrasound elastography can effectively distinguish benign from malignant breast lesions.

## Contribution

The study validates the EI/BI ratio as a reliable non-invasive tool for breast cancer characterization.

## Key findings

- The EI/BI ratio was ≥1 in 29.6% of cases, all of which were malignant.
- The EI/BI ratio showed 96.3% diagnostic accuracy in differentiating benign and malignant lesions.
- A statistically significant correlation was found between the EI/BI ratio and histopathology results.

## Abstract

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.

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

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.

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.

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

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

## Linked entities

- **Diseases:** breast cancer (MONDO:0004989)

## Full-text entities

- **Diseases:** BC (MESH:D001943), fibroadenomas (MESH:D018226), malignancy (MESH:D009369), breast lesions (MESH:D061325)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

17 references — full list in the complete paper: https://tomesphere.com/paper/PMC12339783/full.md

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Source: https://tomesphere.com/paper/PMC12339783