Non-Invasive Assessment of Tertiary Lymphoid Structure in Hepatocellular Carcinoma Based on Multi-Parameter Imaging: From Tumor Immunobiology to Immunotherapy Benefit Prediction

Abstract

Simple Summary Hepatocellular carcinoma is a deadly liver cancer where immunotherapy helps only some patients. Tertiary lymphoid structures are immune cell clusters in and around tumors that predict immunotherapy response, but detecting them currently requires invasive biopsies that risk missing these structures due to tumor heterogeneity. This review summarizes the biological characteristics and clinical significance of TLSs in hepatocellular carcinoma, with emphasis on recent advances in non-invasive TLS assessment via multi-parametric imaging. It further explores the integration of these imaging technologies with large-scale AI models for prognostic prediction and immunotherapy response evaluation.