Fig. 4

a Flowchart summarizing patient selection and allocation to the training cohort, validation cohort, and test cohort. b Flowchart of this study, the process of feature extraction, model development, and validation using radiomics, deep learning, and clinical data. c Workflow of deep learning radiomics. The procedure involves four essential steps: (1) Annotation and segmentation: Identifying and outlining areas of interest (ROIs) on medical images. (2) Feature extraction: Deep learning features were extracted using a Vision Transformer-based model. (3) Feature selection and modeling: Applying statistical and machine learning methods approaches to select significant predictive features and establish the model. (4) Model assessment: Evaluating predictive performance and clinical significance with methods, such as calibration curves, ROC analysis, and decision curves