Toward Robust Lung Cancer Diagnosis: Integrating Multiple CT Datasets, Curriculum Learning, and Explainable AI

<b>Background and Objectives:</b> Computer-aided diagnostic systems have achieved remarkable success in the medical field, particularly in diagnosing malignant tumors, and have done so at a rapid pace. However, the generalizability of the results remains a challenge for researchers and decreases the credibility of these models, which represents a point of criticism by physicians and specialists, especially given the sensitivity of the field. This study proposes a novel model based on deep learning to enhance lung cancer diagnosis quality, understandability, and generalizability. <b>Methods:</b> The proposed approach uses five computed tomography (CT) datasets to assess diversity and heterogeneity. Moreover, the mixup augmentation technique was adopted to facilitate the reliance on salient characteristics by combining features and CT scan labels from datasets to reduce their biases and subjectivity, thus improving the model's generalization ability and enhancing its robustness. Curriculum learning was used to train the model, starting with simple sets to learn complicated ones quickly. <b>Results:</b> The proposed approach achieved promising results, with an accuracy of 99.38%; precision, specificity, and area under the curve (AUC) of 100%; sensitivity of 98.76%; and F1-score of 99.37%. Additionally, it scored a 00% false positive rate and only a 1.23% false negative rate. An external dataset was used to further validate the proposed method's effectiveness. The proposed approach achieved optimal results of 100% in all metrics, with 00% false positive and false negative rates. Finally, explainable artificial intelligence (XAI) using Gradient-weighted Class Activation Mapping (Grad-CAM) was employed to better understand the model. <b>Conclusions:</b> This research proposes a robust and interpretable model for lung cancer diagnostics with improved generalizability and validity. Incorporating mixup and curriculum training supported by several datasets underlines its promise for employment as a diagnostic device in the medical industry.