The different subsets of TILs suppress or support the growth of tumor or metastasis through direct interactions and production of soluble factors such as growth factors, cytokines, and chemokines. TILs play an important and diverse role in the tumorigenesis of cancers. A tumor’s immune profile is characterized by analyzing at various parameters such as the density, composition, location, and functional state of TILs. The TILs consist of T lymphocytes (TCRαβ+ T cells, CD8+ TCRαβ T cells, CD4+ TCRαβ+ T cells, TCRγδ+ T cells), B lymphocytes (antigen-presenting B cells, antibody-producing B cells, regulatory B cells) and innate lymphoid cells (natural killer cells and helper-like innate lymphoid cells). Tumor infiltrating lymphocytes (TILs), macrophages, dendritic cells (DC), mast cells, and cells comprise the tumor immune microenvironment. However, in recent years there has been increasing interest in using the immune contexture of the primary tumors to predict the patient’s prognosis by looking at the disease-free survival (DFS) and overall survival (OS). The patient prognosis in various types of cancers has traditionally been predicted with the use of the TNM staging guidelines provided by the American Joint Committee on Cancer and Union for International Cancer Control. The detailed approach provided herein is intended to provide the reader with the knowledge necessary to not only interpret studies containing such data but also design and apply these tools for clinical practice and future research studies. This review provides a detailed description of different technologies used for immune assessment and analysis of the data collected from the use of these technologies. Therefore, interventional radiologists (IRs) play an essential role in the evaluation of patients treated with systemically administered immunotherapies. Image-guided tissue sampling is a cornerstone in the diagnosis, stratification, and longitudinal evaluation of therapeutic efficacy for cancer patients receiving immunotherapies. Different technologies can be used for the evaluation of the tumor microenvironment, all of which require a tissue or cell sample. The tumor microenvironment of patients with cancers consists of different types of lymphocytes, tumor-infiltrating leukocytes, dendritic cells, and others. In recent years there has been increased interest in using the immune contexture of the primary tumors to predict the patient’s prognosis.
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