Turning the Tide—Artificial Intelligence in the Evolving Landscape of Liver Cancer

Background/Objectives: Liver cancer is an exceedingly heterogeneous malignancy with high mortality rates, and despite extensive research, there have been no significant improvements in treatment outcomes. In the process of navigating the complex landscape of liver cancer, AI has arisen as the “knight in shining armour”, sparking hope and offering invaluable insight into early detection, diagnosis, staging, treatment selection, and post-treatment surveillance. By integrating imaging, clinical, pathological, and molecular data, AI emerges as a transformative tool that offers unique opportunities to enhance patient care. Methods: A comprehensive literature search of PubMed and Scopus, was conducted using the terms “artificial intelligence,” “machine learning,” “deep learning,” “radiomics,” and “liver cancer.” Eligible studies included peer-reviewed original research applying AI to detection, diagnosis, prognosis, treatment planning, or surveillance of liver cancer. Key findings are organized along the clinical continuum. Results: Imaging-based AI models for tumor detection were the most advanced, with several achieving diagnostic accuracy above 90% in retrospective studies. Applications for treatment decision-making are emerging, but most remain at proof-of-concept stages. Generally, few of these innovations have progressed to large-scale clinical trials or received regulatory approval, slowing their integration into clinical practice. Conclusions: This narrative review highlights AI’s potential to transform liver cancer management and addresses the ethical, regulatory, and logistical barriers to its clinical adoption, serving as a call to action for integrating AI into practice to improve patient outcomes.