Fig. 2

The construction methodology of clinical, CT, Radiomics, and combined model. A large-scale clinical cohort was used to train the clinical model, while imaging data were collected from high-risk individuals identified through propensity score matching based on clinical information to construct an imaging cohort for training the CT and radiomics models. Then, a clinical model, a CT model, and a radiomics model were constructed using univariate logistic regression. Subsequently, a combined model was developed by integrating the clinical, CT, and radiomics models, with positivity defined as all three models being positive at a 90% sensitivity threshold. Finally, the models were evaluated using a temporal validation cohort. PSM = propensity score matching