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Purpose <p>This prospective study evaluates the exploratory value of tumor and liver stiffness, measured pre-operatively by 2D shear wave elastography (2D-SWE), in patients with liver cancer undergoing locoregional therapies, including ablation, transarterial chemoembolization (TACE), and transarterial radioembolization (TARE). The aim is to assess whether stiffness changes occur after treatment and to explore their possible association with clinical outcomes.</p> Methods <p>100 patients with liver cancer eligible for locoregional treatment were enrolled. Tumoral tissue, peritumoral area, and proximal liver tissue stiffness were evaluated by 2D-SWE before treatment and one month afterward. Clinical and radiological data were collected, including tumor response up to 6 months. The final series consisted of 76 patients due to exclusion based on technical limitations in elastography acquisition, inability to undergo treatment, or loss to follow-up. Correlations between stiffness, pathological characteristics, and clinical outcomes were statistically assessed. Subgroup analyses were performed by treatment type but given the sample size, these results should be interpreted with caution and as exploratory.</p> Results <p>Baseline tumor stiffness showed no correlation tumor type (<i>p</i> = 0.48) or lesion size (<i>p</i> = 0.35). Tumor stiffness increased after ablation (<i>p</i> = 0.02) and TACE (<i>p</i> = 0.04) but remained stable following TARE (<i>p</i> = 0.69). No significant changes were detected in peritumoral or liver stiffness after treatment. Despite these findings, no significant correlation was found between baseline tumor stiffness (<i>p</i> = 0.72), peritumoral stiffness (<i>p</i> = 0.61), liver stiffness (<i>p</i> = 0.29) and short-term clinical outcomes.</p> Conclusions <p>2D-SWE showed measurable changes in tumor stiffness after locoregional treatments, suggesting a potential role in monitoring tissue alterations. However, no evidence was found to support its ability to predict treatment response or clinical outcomes. These findings should be interpreted as preliminary, and further validation in larger and homogeneous cohorts is needed.</p>

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“Liver stiffness variations after locoregional treatment do not predict outcomes in liver cancer: limitations of elastography as a prognostic tool”

  • 期刊论文

  • 发表日期：

    2026年3月9日

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  • Serena Pisoni,
  • Daniel Pérez Enguix,
  • Adrián Picado Bermúdez,
  • José J. Martínez-Rodrigo,
  • Luis Martí-Bonmatí

摘要

Purpose

This prospective study evaluates the exploratory value of tumor and liver stiffness, measured pre-operatively by 2D shear wave elastography (2D-SWE), in patients with liver cancer undergoing locoregional therapies, including ablation, transarterial chemoembolization (TACE), and transarterial radioembolization (TARE). The aim is to assess whether stiffness changes occur after treatment and to explore their possible association with clinical outcomes.

Methods

100 patients with liver cancer eligible for locoregional treatment were enrolled. Tumoral tissue, peritumoral area, and proximal liver tissue stiffness were evaluated by 2D-SWE before treatment and one month afterward. Clinical and radiological data were collected, including tumor response up to 6 months. The final series consisted of 76 patients due to exclusion based on technical limitations in elastography acquisition, inability to undergo treatment, or loss to follow-up. Correlations between stiffness, pathological characteristics, and clinical outcomes were statistically assessed. Subgroup analyses were performed by treatment type but given the sample size, these results should be interpreted with caution and as exploratory.

Results

Baseline tumor stiffness showed no correlation tumor type (p = 0.48) or lesion size (p = 0.35). Tumor stiffness increased after ablation (p = 0.02) and TACE (p = 0.04) but remained stable following TARE (p = 0.69). No significant changes were detected in peritumoral or liver stiffness after treatment. Despite these findings, no significant correlation was found between baseline tumor stiffness (p = 0.72), peritumoral stiffness (p = 0.61), liver stiffness (p = 0.29) and short-term clinical outcomes.

Conclusions

2D-SWE showed measurable changes in tumor stiffness after locoregional treatments, suggesting a potential role in monitoring tissue alterations. However, no evidence was found to support its ability to predict treatment response or clinical outcomes. These findings should be interpreted as preliminary, and further validation in larger and homogeneous cohorts is needed.