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This review aims to synthesize the imaging features associated with these HCC subtypes and discuss their potential to guide therapeutic decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      We searched PubMed and Embase for articles published from September 2004 to December 2024. The search strategy combined terms for imaging modalities (\u201cCT,\u201d \u201cMRI\u201d), the primary disease (\u201chepatocellular carcinoma\u201d), and various molecular and pathological subtypes (e.g., \u201cmacrotrabecular-massive,\u201d \u201csteatohepatitic,\u201d \u201cCK19,\u201d and \u201c\n                      <jats:italic>CTNNB1<\/jats:italic>\n                      \u201d).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HCC is a biologically heterogeneous malignancy with varied prognosis and sensitivity to treatment. Assessment of its molecular and pathological subtypes relies on invasive histopathological examination, which is subject to sampling errors and often unavailable prior to treatment selection. A growing body of evidence suggests that radiologic features aid in the non-invasive classification of HCC subtypes, thereby informing individualized therapy. Given the substantial overlap between molecular, pathological, and imaging features, this review hypothesize that a comprehensive phenotyping system integrating all these information could significantly enhance personalized prognostication and treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Radiologic imaging features not only provide valuable information for identifying molecular and pathological subtypes of HCC but also serve as practical tools to guide individualized therapeutic decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Can CT and MRI reliably infer the molecular classification and pathological subtypes that drive prognosis in HCC<\/jats:italic>\n                      ?\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Several imaging features have been found to reflect underlying molecular and pathological subtypes, but they do not demonstrate a one-to-one correlation<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>An integrated classification system incorporating clinical, imaging, pathological, and molecular data may help mitigate the limitations of histologic and molecular analyses and facilitate individualized prognostication<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-025-12075-1","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:02:50Z","timestamp":1761843770000},"page":"2744-2763","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Imaging for molecular and pathological subtyping of hepatocellular carcinoma\u2014a critical appraisal and future directions"],"prefix":"10.1007","volume":"36","author":[{"given":"Xinyuan","family":"Jia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanyu","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yali","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claude B.","family":"Sirlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7269-2101","authenticated-orcid":false,"given":"Bin","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanshu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"12075_CR1","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/S0140-6736(22)01200-4","volume":"400","author":"A Vogel","year":"2022","unstructured":"Vogel A, Meyer T, Sapisochin G, Salem R, Saborowski A (2022) Hepatocellular carcinoma. 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Claude B. Sirlin reports payment to the institution for research grants from ACR, Bayer, Foundation of NIH, GE, Gilead, Pfizer, Philips, Siemens, and V Foundation. Payment to institution for lab service agreements with OrsoBio, Enanta, Gilead, ICON, Intercept, Nusirt, Shire, Synageva, and Takeda. Payment to the institution for institutional consulting for BMS, Exact Sciences, IBM-Watson, and Pfizer. Personal consulting for Altimmune, Ascelia Pharma, Blade, Boehringer, Epigenomics, Guerbet, Livivos, and Novo Nordisk. Payment to self for royalties and\/or honoraria from Medscape, Wolters Kluwer, and HealthProMatch. Ownership of stock options in Livivos; unpaid advisory board position in Quantix Bio; executive position for Livivos (Chief Medical Officer, unsalaried position with stock options and stock) through June 28, 2023; and principal Scientific Advisor to Livivos (unsalaried position with stock options and stock) since June 28, 2023. Payment to self for serving as a speaker for HealthProMatch; support for attending meetings and\/or travel from Fundacion Santa Fe, Congreso Argentino de Diagn\u00f3stico por Im\u00e1genes, Stanford, Jornada Paulista de Radiologia, Ascelia Pharma, RSNA, Sociedad Radiol\u00f3gica de Puerto Rico, Hospital Espa\u00f1ol Auxilio Mutuo de Puerto Rico, Paris MASH, Liver Forum, University of Cincinnati, University of Mississippi. Member (no payment) of the Data Safety Monitoring Board for the National Cancer Institute-funded Early Detection Research Network. Equipment loans to the institution from Butterfly, GE, Siemens, and Mayo. Provision of contrast material to the institution from Bayer.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was not required for this study because this is a Review article.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was not required because this is a Review article.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"None.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}