Abstract
BackgroundEarly information on treatment response of HCC to local ablative therapy is crucial. Elastography as a non-invasive method has recently been shown to play a potential role in distinguishing between benign and malignant liver lesions. Elastography of hepatocellular carcinoma (HCC) in early response to local ablative therapy has not been studied to date.MethodsWe prospectively included a cohort of 14 patients with diagnosis of HCC who were treated with local ablative therapy (transarterial chemoembolization, TACE and/or radiofrequency ablation, RFA). We used 2D shear-wave elastography (RT 2D-SWE) to examine stiffness of HCC lesion before and 3, 30 and 90 days after local ablative therapy. Contrast-enhanced imaging after 90 days was performed to evaluate treatment response. Primary endpoint was stiffness of HCC in response to local ablative therapy. Secondary end point was tumor recurrence.ResultsStiffness of HCC nodules and liver showed no significant difference prior to local ablative therapy. As early as three days after treatment, stiffness of responding HCC was significantly higher compared to non-responding. Higher stiffness before treatment was significantly associated with tumor recurrence.ConclusionNodule stiffness in general and RT 2D-SWE in particular could provide a useful tool for early prediction of HCC response to local ablative therapy.
Highlights
In recent years, liver stiffness assessed by different elastography techniques has become a standard tool for non-invasive staging of liver fibrosis and detection of clinically significant portal hypertension in patients with chronic liver disease [1,2,3]
Elastography of hepatocellular carcinoma (HCC) in early response to local ablative therapy has not been studied to date
We prospectively included a cohort of 14 patients with diagnosis of HCC who were treated with local ablative therapy
Summary
Liver stiffness assessed by different elastography techniques (transient, shear wave, magnetic resonance, etc.) has become a standard tool for non-invasive staging of liver fibrosis and detection of clinically significant portal hypertension in patients with chronic liver disease [1,2,3]. While contrast-enhanced imaging is the first-line approach in the diagnosis of HCC, recent reports show that the non-invasively measured stiffness of hepatic nodules could help to distinguish between malignant and benign liver lesions. After treatment, recurrence of HCC, other than the target lesions (non-target lesions, Non-TL) is crucial for patient outcome and therapeutic strategy [10]. This prospective study investigated for the first time whether magnitude and development of nodule stiffness assessed by real-time two-dimensional shear wave elastography (RT 2D-SWE) is associated with response of HCC to local ablative therapy and occurrence of Non-TL. Elastography of hepatocellular carcinoma (HCC) in early response to local ablative therapy has not been studied to date
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