AFP and neoplasm: Models' performance was evaluated and compared using AUC analyses and DeLong tests.<h4>Results</h4>The combined model [serum AFP ≥ 200 ng/mL, non-smooth tumor margin, internal arteries, and lower tumor-to-liver density ratio in the portal venous phase (P-TLR)] achieved optimal predictive performance for V/M + HCC, with training AUC of 0.784 and 0.782 pre- and post-PSM, and external validating AUC of 0.794.