Integrated ensemble CNN and explainable AI for COVID-19 diagnosis from CT scan and X-ray images

In light of the ongoing battle against COVID-19, while the pandemic may eventually subside, sporadic cases may still emerge, underscoring the need for accurate detection from radiological images. However, the limited explainability of current deep learning models restricts clinician acceptance. To address this issue, our research integrates multiple CNN models with explainable AI techniques, ensuring model interpretability before ensemble construction. Our approach enhances both accuracy and interpretability by evaluating advanced CNN models on the largest publicly available X-ray dataset, COVIDx CXR-3, which includes 29,986 images, and the CT scan dataset for SARS-CoV-2 from Kaggle, which includes a total of 2,482 images. We also employed additional public datasets for cross-dataset evaluation, ensuring a thorough assessment of model performance across various imaging conditions. By leveraging methods including LIME, SHAP, Grad-CAM, and Grad-CAM++, we provide transparent insights into model decisions. Our ensemble model, which includes DenseNet169, ResNet50, and VGG16, demonstrates strong performance. For the X-ray image dataset, sensitivity, specificity, accuracy, F1-score, and AUC are recorded at 99.00%, 99.00%, 99.00%, 0.99, and 0.99, respectively. For the CT image dataset, these metrics are 96.18%, 96.18%, 96.18%, 0.9618, and 0.96, respectively. Our methodology bridges the gap between precision and interpretability in clinical settings by combining model diversity with explainability, promising enhanced disease diagnosis and greater clinician acceptance.