Advances in imaging techniques for tumor microenvironment evaluation in hepatocellular carcinoma

Abstract

The tumor microenvironment (TME) plays a critical role in the development and treatment of liver cancer, which ranks sixth in incidence and third in mortality worldwide, according to the “Global Cancer Statistics 2022”. Hepatocellular carcinoma (HCC), the most common form of liver cancer, is heavily influenced by the TME, which affects tumor growth, invasion, metastasis, and the response to various treatments. Despite advancements in surgery, liver transplantation, targeted therapies, and immunotherapy, the complexity of the TME often limits treatment efficacy, especially in advanced-stage HCC cases. The TME consists of a dynamic interaction between tumor cells, immune cells, fibroblasts, blood vessels, and signaling molecules, all of which contribute to cancer progression and therapy resistance. Assessing the HCC TME is essential for designing effective, personalized treatments and improving patient outcomes. Recent research highlights the value of imaging technologies as non-invasive tools to evaluate the TME, offering new possibilities for more targeted therapies and better prognosis monitoring in HCC patients.

Keywords: Hepatocellular carcinoma; Tumor microenvironment; Imaging diagnosis; Non-invasive assessment; Molecular imaging

Core Tip: Imaging technologies play a crucial role in the preoperative assessment of the tumor microenvironment in hepatocellular carcinoma. By evaluating key features such as vascularity, immune infiltration, and stromal components, these techniques provide valuable insights into tumor biology. A comprehensive assessment of the tumor microenvironment allows for the development of personalized treatment strategies, optimizing therapeutic outcomes for liver cancer patients. Advanced imaging modalities, including magnetic resonance imaging, computed tomography, and positron emission tomography, help predict tumor behavior and response to treatment, ultimately contributing to more precise and effective clinical decision-making.