Poor tumour perfusion (low flow/ART and high MTT) was associated with high expression of HCC markers, VEGFA and immune checkpoints CD274 and CTLA4. The relation with HCC markers may be related to tumour progression, which is associated with decreased arterial flow, secondary to increased interstitial pressure and resulting closure of arterial capillaries45, and higher expression of HCC markers, including HSP70 and LYVE146, 47. Here, VEGFA is linked to hepatocellular carcinoma.