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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">P. Tiwari</span> and <span class="highwire-citation-author" data-delta="1">A. Madabhushi</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">March 2017,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">E22; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5120 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14691--6594386025" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">P. Tiwari </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Biomedical Engineering
Case Western Reserve University
Cleveland, Ohio</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BTiwari%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Tiwari%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.%2BTiwari%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-9477-4856" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Tiwari</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">A. Madabhushi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Biomedical Engineering
Case Western Reserve University
Cleveland, Ohio</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BMadabhushi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Madabhushi%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BMadabhushi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-5741-0399" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Madabhushi</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view "><span class="highwire-journal-article-marker-start"></span><p id="p-1">We thank Larroza and colleagues for their interest in our article “Computer-Extracted Texture Features to Distinguish Cerebral Radionecrosis from Recurrent Brain Tumors on Multiparametric MRI: A Feasibility Study.”<sup><a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a></sup></p><p id="p-2">We are responding to the following comment by Larroza and colleagues in their letter: “Our results may have been affected by the classifier being contaminated by sections from the same patient being used in both the training and testing sets during classification.”</p><p id="p-3">Our understanding of the analysis in the article by Larroza et al<sup><a id="xref-ref-2-1" class="xref-bibr" href="#ref-2">2</a></sup> was that it was done on a lesion basis. The study comprised 115 lesions from 73 unique patient studies, with some patients having &gt;1 lesion in different regions of the brain. Specifically, as mentioned in Larroza et al, the authors merged training and test sets and performed repeated training/test splits 100 times, holding 70% in training and then averaging the area under the curve values on test sets.</p><p id="p-4">After we read the article by Larroza et al,<sup><a id="xref-ref-2-2" class="xref-bibr" href="#ref-2">2</a></sup> it was not clear whether lesions from the same patient appeared simultaneously in the training and test sets. This could bias analysis because adjacent MR imaging sections tend to be highly correlated; thus, the features extracted (albeit from 2 different lesions from the same patient) might also be correlated. Thus, for a patient, including features from one lesion in training and features from another lesion in the test set within the same iteration of cross-validation may lead to overfitting<sup><a id="xref-ref-3-1" class="xref-bibr" href="#ref-3">3</a></sup> and may yield unreliable results. It is not clear that patient-specific separation across lesions was ensured during their cross-validation analysis.</p><div class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-38.3.E22.1" data-doi="10.3174/ajnr.A4931"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Tiwari</span>  <span class="cit-name-given-names">P</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Prasanna</span>  <span class="cit-name-given-names">P</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Wolansky</span>  <span class="cit-name-given-names">L</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Computer-extracted texture features to distinguish cerebral radionecrosis from recurrent brain tumors on multiparametric MRI: a feasibility study</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2016</span>;<span class="cit-vol">37</span>:<span class="cit-fpage">2231</span>–<span class="cit-lpage">36</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3174/ajnr.A4931</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>27633806</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czoxMDoiMzcvMTIvMjIzMSI7czo0OiJhdG9tIjtzOjE5OiIvYWpuci8zOC8zL0UyMi5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a><div class="cit ref-cit ref-journal" id="cit-38.3.E22.2" data-doi="10.1002/jmri.24913"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Larroza</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Moratal</span>  <span class="cit-name-given-names">D</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Paredes-Sánchez</span>  <span class="cit-name-given-names">A</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Support vector machine classification of brain metastasis and radiation necrosis based on texture analysis in MRI</span>. <abbr class="cit-jnl-abbrev">J Magn Reson Imaging</abbr> <span class="cit-pub-date">2015</span>;<span class="cit-vol">42</span>:<span class="cit-fpage">1362</span>–<span class="cit-lpage">68</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1002/jmri.24913</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>25865833</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1002/jmri.24913&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=25865833&amp;link_type=MED&amp;atom=%2Fajnr%2F38%2F3%2FE22.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a><div class="cit ref-cit ref-book" id="cit-38.3.E22.3"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Hastie</span>  <span class="cit-name-given-names">T</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Tibishirani</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Friedman</span>  <span class="cit-name-given-names">J</span></span></li></ol><cite>. <span class="cit-source">The Elements of Statistical Learning: Data Mining, Inference, and Prediction: Springer Series in Statistics</span>. <span class="cit-edition">2nd ed</span>. <span class="cit-publ-name">New York</span>: <span class="cit-publ-loc">Springer-Verlag</span>; <span class="cit-pub-date">2009</span>:<span class="cit-comment">chap 7</span></cite></div><div class="cit-extra"></div></div></li></ol></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2017 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 38</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 3 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Mar 2017 </div></div>
      
      
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