Fig. 6

Decision curve analysis in predicting 5-year disease-free survival in patients with invasive breast cancer for the clinical traditional MRI model, the multi-modal radiomics signature, and the multi-modal clinical imaging model when the internal and external testing sets were merged into a testing set (a), and when the training, internal and external testing sets were merged into a whole dataset (b). The net benefit, measured on the y-axis, was calculated by summing the benefits (true positive results) and subtracting the harms (false positive results), weighing the latter by a factor related to the relative harm of an undetected cancer compared with the harm of unnecessary treatment. The multi-modal clinical imaging model had the highest net benefit compared with both the other models and simple strategies such as follow-up of all patients (gray line) or no patients (horizontal black line) within the probability threshold range of 0.00-0.45 at which a patient would choose to undergo imaging follow-up. MRI, magnetic resonance imaging