Enhanced tuberculosis detection using Vision Transformers and explainable AI with a Grad-CAM approach on chest X-rays.

Publication date: Mar 24, 2025

Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a leading global health challenge, especially in low-resource settings. Accurate diagnosis from chest X-rays is critical yet challenging due to subtle manifestations of TB, particularly in its early stages. Traditional computational methods, primarily using basic convolutional neural networks (CNNs), often require extensive pre-processing and struggle with generalizability across diverse clinical environments. This study introduces a novel Vision Transformer (ViT) model augmented with Gradient-weighted Class Activation Mapping (Grad-CAM) to enhance both diagnostic accuracy and interpretability. The ViT model utilizes self-attention mechanisms to extract long-range dependencies and complex patterns directly from the raw pixel information, whereas Grad-CAM offers visual explanations of model decisions about highlighting significant regions in the X-rays. The model contains a Conv2D stem for initial feature extraction, followed by many transformer encoder blocks, thereby significantly boosting its ability to learn discriminative features without any pre-processing. Performance testing on a validation set had an accuracy of 0. 97, recall of 0. 99, and F1-score of 0. 98 for TB patients. On the test set, the model has accuracy of 0. 98, recall of 0. 97, and F1-score of 0. 98, which is better than existing methods. The addition of Grad-CAM visuals not only improves the transparency of the model but also assists radiologists in assessing and verifying AI-driven diagnoses. These results demonstrate the model’s higher diagnostic precision and potential for clinical application in real-world settings, providing a massive improvement in the automated detection of TB.

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Concepts Keywords
Cnns Chest X-rays
Informatics Convolutional neural networks
Mycobacterium Deep learning
Tuberculosis Diagnostic accuracy
Explainable AI
Grad-CAM
Humans
Medical imaging
Neural Networks, Computer
Radiography, Thoracic
Self-attention
Tuberculosis detection
Tuberculosis, Pulmonary
Vision Transformer

Semantics

Type Source Name
disease MESH tuberculosis
pathway KEGG Tuberculosis
drug DRUGBANK Flunarizine
drug DRUGBANK Tropicamide
pathway REACTOME Reproduction
disease MESH COVID 19
disease MESH infections
disease MESH tic
disease IDO quality
disease IDO process
disease IDO history
disease MESH tuberculous meningitis
disease MESH privacy
drug DRUGBANK Nonoxynol-9
disease MESH aids
disease MESH pulmonary diseases
pathway REACTOME Translation
drug DRUGBANK Coenzyme M
drug DRUGBANK Esomeprazole
drug DRUGBANK Polyethylene glycol
drug DRUGBANK Vildagliptin
disease MESH anomalies
disease IDO algorithm
drug DRUGBANK Saquinavir
disease MESH confusion
drug DRUGBANK MCC
drug DRUGBANK Cysteamine
drug DRUGBANK Gold
disease MESH pneumonia
disease MESH pulmonary tuberculosis
disease IDO host
disease IDO bacteria
disease MESH brain tumors
disease MESH extensively drug resistant tuberculosis

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