Abstract:Background: An accurate and automatic computer-aided multi-class decision support system to classify the magnetic resonance imaging (MRI) scans of the human brain as normal, Alzheimer, AIDS, cerebral calcinosis, glioma, or metastatic, which helps the radiologists to diagnose the disease in brain MRIs is created. Methods: The performance of the proposed system is validated by using benchmark MRI datasets (OASIS and Harvard) of 310 patients. Master features of the images are extracted using a fast discrete wavelet transform (DWT), then these discriminative features are further analysed by principal component analysis (PCA). Different subset sizes of principal feature vectors are provided to five different decision models. The classification models include the J48 decision tree, k-nearest neighbour (kNN), random forest (RF), and least-squares support vector machine (LS-SVM) with polynomial and radial basis kernels. Results: The RF-based classifier outperformed among all compared decision models and achieved an average accuracy of 96% with 4% standard deviation, and an area under the receiver operating characteristic (ROC) curve of 99%. LS-SVM (RBF) also shows promising results (i.e., 89% accuracy) when the least number of principal features was used. Furthermore, the performance of each classifier on different subset sizes of principal features was (80%-96%) for most performance metrics. Conclusion: The presented medical decision support system demonstrates the potential proof for accurate multi-class classification of brain abnormalities; therefore, it has a potential to use as a diagnostic tool for the medical practitioners.