免疫疗法的出现是癌症治疗领域的重大突破，也使得肿瘤微环境（TME）成为研究的重要领域。对TME的深入理解在临床上具有重要且广泛的临床意义。放射组学在TME和癌症预后的全面评估中的应用越来越多。类似地，基于病理图像的病理组学能够提供更全面的肿瘤全景视角和微观信息。病理组学与放射组学的结合革新了“数字活检”的概念。随着基因组学和转录组学的不断发展，将放射组学与基因组学和转录组学的数据集集成可以进一步揭示肿瘤和微环境的异质性，并与生物学意义建立相关性。因此，数字图像特征（放射组学、病理组学）和遗传表型（基因组学）的协同分析可以全面解码和表征TME的异质性，并预测癌症预后。本综述全面总结了用于预测TME的重要放射组学生物标志物的研究，重点强调了放射组学、基因组学、转录组学和病理组学之间的相互作用，以及多组学在解码TME和预测癌症预后方面的应用。最后，我们讨论了多组学研究中的挑战和机遇。总之，本综述突出了放射组学和多组学关联在TME评估和癌症预后评估中的关键作用。放射组学、病理组学、基因组学和转录组学的综合分析是一项具有重要研究意义和价值的有前景的研究方向，可用于全面评估TME并预测癌症预后。© 2023. BioMed Central Ltd., part of Springer Nature.

The advent of immunotherapy, a groundbreaking advancement in cancer treatment, has given rise to the prominence of the tumor microenvironment (TME) as a critical area of research. The clinical implications of an improved understanding of the TME are significant and far-reaching. Radiomics has been increasingly utilized in the comprehensive assessment of the TME and cancer prognosis. Similarly, the advancement of pathomics, which is based on pathological images, can offer additional insights into the panoramic view and microscopic information of tumors. The combination of pathomics and radiomics has revolutionized the concept of a "digital biopsy". As genomics and transcriptomics continue to evolve, integrating radiomics with genomic and transcriptomic datasets can offer further insights into tumor and microenvironment heterogeneity and establish correlations with biological significance. Therefore, the synergistic analysis of digital image features (radiomics, pathomics) and genetic phenotypes (genomics) can comprehensively decode and characterize the heterogeneity of the TME as well as predict cancer prognosis. This review presents a comprehensive summary of the research on important radiomics biomarkers for predicting the TME, emphasizing the interplay between radiomics, genomics, transcriptomics, and pathomics, as well as the application of multiomics in decoding the TME and predicting cancer prognosis. Finally, we discuss the challenges and opportunities in multiomics research. In conclusion, this review highlights the crucial role of radiomics and multiomics associations in the assessment of the TME and cancer prognosis. The combined analysis of radiomics, pathomics, genomics, and transcriptomics is a promising research direction with substantial research significance and value for comprehensive TME evaluation and cancer prognosis assessment.© 2023. BioMed Central Ltd., part of Springer Nature.