Extreme learning machine (ELM) is a training algorithm for single hidden layer feedforward neural network (SLFN), which converges much faster than traditional methods and yields promising performance. In this paper, we hope to present a comprehensive review on ELM. Firstly, we will focus on the theoretical analysis including universal approximation theory and generalization. Then, the various improvements are listed, which help ELM works better in terms of stability, efficiency, and accuracy. Because of its outstanding performance, ELM has been successfully applied in many real-time learning tasks for classification, clustering, and regression. Besides, we report the applications of ELM in medical imaging: MRI, CT, and mammogram. The controversies of ELM were also discussed in this paper. We aim to report these advances and find some future perspectives.

(Aim) Classification of brain images as pathological or healthy case is a key pre-clinical step for potential patients. Manual classification is irreproducible and unreliable. In this study, we aim to develop an automatic classification system of brain images in magnetic resonance imaging (MRI). (Method) Three datasets were downloaded from the Internet. Those images are of T2-weighted along axial plane with size of 256 × 256. We utilized an s-level decomposition on the basis of dual-tree complex wavelet transform (DTCWT), in order to obtain 12s “variance and entropy (VE)” features from each subband. Afterwards, we used support vector machine (SVM) and its two variants: the generalized eigenvalue proximal SVM (GEPSVM) and the twin SVM (TSVM), as the classifiers. In all, we proposed three novel approaches: DTCWT + VE + SVM, DTCWT + VE + GEPSVM, and DTCWT + VE + TSVM. (Results) The results showed that our “DTCWT + VE + TSVM” obtained an average accuracy of 99.57%, which was not only better than the two other proposed methods, but also superior to 12 state-of-the-art approaches. In addition, parameter estimation showed the classification accuracy achieved the largest when the decomposition level s was assigned with a value of 1. Further, we used 100 slices from real subjects, and we found our proposed method was superior to human reports from neuroradiologists. (Conclusions) This proposed system is effective and feasible.