Fig. 3.

Lymph node–specific decision curve. The decision curve analysis plots the expected net benefit against the threshold capacity on the test set. The net benefit is calculated by subtracting the proportion of false-positive lymph nodes from the proportion of true-positive lymph nodes, weighted by the relative harm of a false-negative and false-positive result. The decision curves for “treating no lymph nodes” and “treating all lymph nodes” are depicted as reference. A decision model shows a clinical benefit if it achieves larger net benefit values than both reference strategies or any other model. This decision curve reflects the treatment decision on the lymph node level. The best radiomic model “Radiomics-combined” was split at an optimal cutpoint which was determined on the training set. It is compared to LN short diameter split at 0.8 cm