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

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.