Intravoxel incoherent motion model for prediction of tertiary lymphoid structures in HCC.

Motivation: Intra-tumoral tertiary lymphoid structures (TLSs) are associated with a favorable prognosis for patients with hepatocellular carcinoma (HCC). Intravoxel incoherent motion (IVIM) sequences describe heterogeneity of tumor components. Goal(s): We aimed to explore the value of intravoxel incoherent motion (IVIM) sequences in predicting TLSs. Approach: IVIM quantitative parameters and radiomics features were obtained. A fusion model based on the above and clinical characteristics was constructed. Receiver operating characteristic curve analysis was performed to assess the diagnostic performance of different models for TLSs prediction. Results: Radiomics features based on IVIM-DWI can be better conducive to preoperative prediction of TLSs in patients than IVIM parameter maps. Impact: TLSs exhibit considerable promise in prognostic prediction and the identification of appropriate candidates for immunotherapy. The fusion model based on the IVIM-DWI showed great performance in predicting TLSs, assisting the selection of clinical immunotherapy patients.