An Explainable YOLO-Based Deep Learning Framework for Pneumonia Detection from Chest X-Ray Images

Pneumonia remains a serious global health issue, particularly affecting vulnerable groups such as children and the elderly, where timely and accurate diagnosis is critical for effective treatment. Recent advances in deep learning have significantly enhanced pneumonia detection using chest X-rays, yet many current methods still face challenges with interpretability, efficiency, and clinical applicability. In this work, we proposed a YOLOv11-based deep learning framework designed for real-time pneumonia detection, strengthened by the integration of Grad-CAM for visual interpretability. To further enhance robustness, the framework incorporated preprocessing techniques such as Contrast Limited Adaptive Histogram Equalization (CLAHE) for contrast improvement, region-of-interest extraction, and lung segmentation, ensuring both precise localization and improved focus on clinically relevant features. Evaluation on two publicly available datasets confirmed the effectiveness of the approach. On the COVID-19 Radiography Dataset, the system reached a macro-average accuracy of 98.50%, precision of 98.60%, recall of 97.40%, and F1-score of 97.99%. On the Chest X-ray COVID-19 & Pneumonia dataset, it achieved 98.06% accuracy, with corresponding high precision and recall, yielding an F1-score of 98.06%. The Grad-CAM visualizations consistently highlighted pathologically relevant lung regions, providing radiologists with interpretable and trustworthy predictions. Comparative analysis with other recent approaches demonstrated the superiority of the proposed method in both diagnostic accuracy and transparency. With its combination of real-time processing, strong predictive capability, and explainable outputs, the framework represents a reliable and clinically applicable tool for supporting pneumonia and COVID-19 diagnosis in diverse healthcare settings.