Eg. by changing PT_INTERP to something else than usual (or dispensing with it, so the binary becomes a static one, still displaying DT_NEEDED), or exploiting bugs in ld.so, so the values shown by readelf become meaningless.

I'm also not entirely sure that readelf/binutils was reviewed from sec-perspective, it might not be out of the question that readelf might show things which are then interpreted differently by either kernel (loading a basic static bin or ld.so/interpreter) or by ld.so itself.