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DOI: 10.48087/BJMS.2026.130316
Authors: Hichem El Azhari BENMAMAR1, Mustapha BOUMENDJEL2, Youcef KHENCHOUL3, Dalal ZERROUK4
Affiliations: 1- Radiologie et imagerie médicale. Centre Hospitalier et Universitaire de Constantine ; Algérie 2- Service de gastro-entérologie, Centre Hospitalier et Universitaire de Constantine – Algérie. 3- Service de chirurgie générale A, Centre Hospitalier et Universitaire de Constantine -Algérie. 4- Service d’oncologie médicale, Centre Hospitalier et Universitaire de Constantine – Algérie.
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and is often associated with a poor prognosis due to its biological and clinical heterogeneity. Imaging plays a central role in diagnosis and can also provide valuable prognostic information. This article aims to summarize the main prognostic and predictive imaging biomarkers of HCC and to discuss their clinical relevance. Tumor features associated with poor prognosis include large tumor size, necrosis, irregular margins, satellite nodules, and bile duct invasion, whereas small tumor size, the presence of intratumoral fat, and T1 hyperintensity on MRI are correlated with favorable outcomes. Identification of these factors helps anticipate the risk of recurrence and guide patient follow-up and treatment strategies. Thus, imaging provides valuable prognostic and predictive biomarkers in HCC, contributing to improved patient stratification and more personalized management. Artificial intelligence and radiomics additionally offer promising perspectives for further refining prognostic and predictive assessments in the future.
Keywords: Hepatocellular carcinoma, Prognostic imaging, LI-RADS, Imaging biomarkers, MRI and CT, Tumor aggressiveness, Microvascular invasion, Diffusion-weighted imaging (ADC), Radiomics, Artificial intelligence.