Change in Two-Dimensional Shear Wave Elastography: A New Predictor of Hepatitis B-Related HCC Progression After...

Ablation is an important therapy for hepatocellular carcinoma (HCC). This study aims to explore the changes in pre- and short-term-post-ablative two-dimensional shear wave elastography (2D-SWE) measurements and assess the feasibility of using pre- and short-term-post-ablative indicators, including 2D-SWE measurements, to predict HCC progression after curative ablation.

A total of 161 treatment-naïve chronic hepatitis B-related HCC patients were divided into training (n = 107) and validation (n = 54) groups. Data, including 2D-SWE measurements (Emean), were collected pre-ablation, 1 mo post-ablation, and at other scheduled follow-ups. The independent predictor of progression-free survival (PFS) was analyzed using Cox regression analysis, and a prediction model was established.

The median follow-up time was 12 mo (range 1-36 mo), and tumor progression occurred in 36 (22.4%) patients. Compared to the pre-ablation, the 1-mo-post-ablative Emean decreased in 40 (24.8%) patients, while increased in 71 (44.1%) patients, and did not significantly change in 50 (31.1%) patients. Cox analysis identified pre-ablative prothrombin time (PT; p = 0.014, HR = 1.54), 1-mo-post-ablative alpha-fetoprotein (AFP; p = 0.014, HR = 1.01), and categorized Emean change between pre-ablative and 1-mo-post-ablative period (with decrease as reference, not-significant-change: p = 0.096, HR = 0.38; increase: p = 0.014, HR = 0.22) as the independent predictor of PFS. The Cox model could significantly predict PFS in both training (p < 0.001, HR = 2.10) and validation (p = 0.009, HR = 1.17) groups.

Longer pre-ablation PT, higher 1-mo post-ablation AFP, and decreased 1-mo post-ablation Emean were associated with shorter post-ablation PFS. Changes in 2D-SWE measurements may serve as a potential indicator of HCC progression after ablation.