Ultrasonographic assessment of chemotherapy-induced peripheral neuropathy after oxaliplatin treatment: an exploratory study

Background Oxaliplatin is used in colorectal cancer treatment (CRC) but frequently causes chemotherapy-induced peripheral neuropathy (CIPN), a cumulative and potentially chronic adverse event. Reliable non-invasive methods for the early detection and monitoring of CIPN are lacking. Shear wave elastography (SWE) is an ultrasound-based technique that quantifies peripheral nerve stiffness and may enable CIPN assessment. Purpose To evaluate the feasibility of SWE for detecting CIPN from oxaliplatin treatment in CRC. Material and Methods In this prospective, single-blinded study, patients with stage III–IV CRC receiving oxaliplatin-based (n = 18) or non-oxaliplatin chemotherapy (n = 12) were assessed at baseline, 3 months, and 6 months. Tibial nerve SWE, cross-sectional area, and diameter were measured using a standardized ultrasound protocol. CIPN symptoms were recorded through structured interviews, yielding composite scores (0–10), with possible CIPN defined as ≥2 points. Healthy controls (n = 9) underwent a single SWE evaluation. Linear mixed-effects models and non-parametric tests were used for longitudinal and group comparisons. Results Nerve diameter increased over time in both groups (+1.50 mm, 95% confidence interval = 0.78–2.21; P <0.001) without between-group differences. SWE showed a trend toward higher tibial nerve stiffness at 6 months in oxaliplatin-treated patients (29.75 vs. 20.81 kPa). Possible CIPN occurred in 70% of oxaliplatin-treated patients versus none in the non-oxaliplatin ( P <0.01). SWE correlated with CIPN scores (ρ = 0.55; P = 0.04). Conclusion SWE is a feasible, non-invasive method, and tibial nerve stiffness was modestly associated with CIPN symptom severity at 6 months. These findings are hypothesis-generating, and larger studies with validated neuropathy instruments are warranted to confirm clinical utility.