How to predict which patients with initially unresectable liver cancer are more likely to respond to conversion therapy remains an important unresolved problem in guiding treatment strategy and surgical timing. Substantial variation exists among patients in their tumor response to the same conversion therapy regimen, and current pretreatment imaging assessment does not adequately capture this inter-individual variability. We hypothesize that baseline tumor viscoelastic parameters measured by three-dimensional magnetic resonance elastography (3D-MRE) differ substantially across patients, and that this inter-individual heterogeneity may be associated with differential response to conversion therapy. This study aims to prospectively evaluate the association between baseline 3D-MRE-derived tumor viscoelastic parameters and pathological response as well as surgical conversion outcomes across patients with liver cancer receiving conversion therapy.
Age 18-75 years
Pathologically or radiologically confirmed diagnosis of initially unresectable liver cancer (hepatocellular carcinoma, intrahepatic cholangiocarcinoma, or liver metastasis)
Planned to receive conversion therapy with the intent of achieving surgical resectability
Child-Pugh class A or B liver function (for patients with primary liver cancer)
Contraindication to MRI
Child-Pugh class C liver function (for patients with primary liver cancer)
Uncontrolled ascites, hepatic encephalopathy, or variceal bleeding within 3 months prior to enrollment
Other concurrent active malignancy