Evolution of nodule stiffness might predict response to local ablative therapy: A series of patients with hepatocellular carcinoma

PLoS One. 2018 Feb 14;13(2):e0192897. doi: 10.1371/journal.pone.0192897. eCollection 2018.


Background: Early 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.

Methods: We 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.

Results: Stiffness 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.

Conclusion: Nodule stiffness in general and RT 2D-SWE in particular could provide a useful tool for early prediction of HCC response to local ablative therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Carcinoma, Hepatocellular / therapy*
  • Catheter Ablation
  • Chemoembolization, Therapeutic
  • Cohort Studies
  • Elasticity
  • Elasticity Imaging Techniques / methods
  • Female
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / therapy*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Prospective Studies
  • Treatment Outcome

Grant support

This work was supported by the Deutsche Forschungsgemeinschaft (grant SFB TRR 57 P18), H2020 European Institute of Innovation and Technology (grant 668031), and Fundación Cellex (PREDICT grant) to JT. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.