肝细胞癌（HCC）研究多年来一直关注非侵asive诊断。现在，由精确特征组成的标准化系统算法作为HCC的诊断影像标记，构成了肝脏影像学的主要创新。在临床实践中，如果影像特征不具体，HCC的诊断主要基于影像学，其次是病理分析。虽然准确的诊断非常重要，但HCC的下一阶段创新很可能包括预测和预后指标。由于影响治疗结果的复杂分子、病理和患者水平因素，HCC是一种生物学上的异质性恶性肿瘤。近年来，系统治疗方面取得了许多进展，以增强和延长现有的大量本地和区域选择。然而，治疗决策的标志既不复杂也不个性化。本评述从患者到影像特征水平概述HCC的预后，重点讨论未来向更个性化治疗指导的方向发展。 ©RSNA，2023。本期的Fowler等人的社论也请参阅。

The focus of hepatocellular carcinoma (HCC) research for many years has been on noninvasive diagnosis. Standardized systematic algorithms composed of combinations of precise features now serve as diagnostic imaging markers of HCC and constitute a major innovation for liver imaging. In clinical practice, the diagnosis of HCC is based primarily on imaging and secondarily on pathologic analysis if the imaging features are not specific. Whereas accurate diagnosis is essential, the next phase of innovation for HCC will likely encompass predictive and prognostic markers. HCC is a biologically heterogeneous malignancy because of complex molecular, pathologic, and patient-level factors that impact the outcomes of treatment. In recent years, there have been many advances in systemic therapy to augment and extend the existing large cache of local and regional options. However, the guideposts for treatment decisions are neither sophisticated nor individualized. This review provides an overview of prognosis in HCC from the patient to the imaging feature level with a focus on future directions toward more individualized treatment guidance.© RSNA, 2023 See also the editorial by Fowler et al in this issue.