The reported rate of intrahepatic recurrence of hepatocellular carcinoma (HCC) after resection is high (up to 50%), even with negative surgical margins, which is postulated to be due to micrometastases. Immunotherapy present new possibilities in cancer treatment with encouraging results in HCC. Selection of patients for immunotherapy may be based on background immune features, thus imaging features associated with immunophenotype may aid in patient selection. Specifically, radiomics features exhibited a fair to excellent diagnostic performance for differentiating tumors with high vs. low/moderate tumor infiltrating lymphocytes (TILs) and presence vs absence of tertiary lymphoid structure (TLS) with AUC range of 0.70-0.95.
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