Background A computer-aided diagnosis (CAD) system based on intensity-invariant magnetic resonance (MR) imaging features was proposed to grade gliomas for general application to various scanning systems and settings. Method In total, 34 glioblastomas and 73 lower-grade gliomas comprised the image database to evaluate the proposed CAD system. For each case, the local texture on MR images was transformed into a local binary pattern (LBP) which was intensity-invariant. From the LBP, quantitative image features, including the histogram moment and textures, were extracted and combined in a logistic regression classifier to establish a malignancy prediction model. The performance was compared to conventional texture features to demonstrate the improvement. Results The performance of the CAD system based on LBP features achieved an accuracy of 93% (100/107), a sensitivity of 97% (33/34), a negative predictive value of 99% (67/68), and an area under the receiver operating characteristic curve (Az) of 0.94, which were significantly better than the conventional texture features: an accuracy of 84% (90/107), a sensitivity of 76% (26/34), a negative predictive value of 89% (64/72), and an Az of 0.89 with respective p values of 0.0303, 0.0122, 0.0201, and 0.0334. Conclusions More-robust texture features were extracted from MR images and combined into a significantly better CAD system for distinguishing glioblastomas from lower-grade gliomas. The proposed CAD system would be more practical in clinical use with various imaging systems and settings.
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