Hybrid Ensemble Learning for Multi-Class Chest X-Ray Classification Using Deep CNN
Hybrid Ensemble Learning for Chest X-Ray Classification
Keywords:
Chest X-ray, Deep Learning, Convolutional Neural Networks, Ensemble Learning, Medical Image Classification, Tuberculosis, PneumoniaAbstract
Background: COVID-19, pneumonia, and TB (tuberculosis) are still the big killers of people suffering from chest disease and continue to be a serious health challenge globally. A timely diagnosis leads to timely treatment and improved patient outcomes. Chest X-ray (CXR) imaging is widely used for diagnostic purposes due to its speed, low cost, and availability in most healthcare facilities. Manual reading of CXR images is, however, challenging because of the similarity in the presentation of radiographic features across various chest diseases.
Methods: This research introduces a hybrid ensemble learning approach to classify chest X-ray images into four classes—Normal, COVID-19, Pneumonia, and Tuberculosis. Three Deep CNN network models, namely Xception, AlexNet, and EfficientNet-B0, were used for deep feature extraction. Additionally, texture features of the images were extracted using Gabor filters. The deep and texture features were combined and classified using logistic regression and a stacking ensemble learning approach. A publicly available chest X-ray image database containing 7,135 X-rays was used, with six-fold stratified cross-validation to assess the proposed approach.
Results: The ensemble models outperformed the individual CNN models. The Average Ensemble produced the best results with an accuracy of 91.18%, an Average Precision (AP) of 96.75%, and an Area Under the ROC Curve (AUC) of 98.87%. The proposed model performs well across all four disease classes. It exhibited high sensitivity in detecting Tuberculosis with considerable stability in classifying Normal, COVID-19, and Pneumonia.
Conclusion: The proposed framework demonstrates the effectiveness of integrating deep learning features, Gabor texture features, and ensemble learning for improved chest X-ray image classification. This can help computer-assisted diagnostics systems and aid medical workers in identifying chest diseases early.
References
Rajaraman S, Antani S, Candemir S, Xue Z, Alderson P, Kohli M, et al. A novel stacked generalization of models for improved TB detection in chest radiographs. 2018. doi: https://doi.org/10.1201/9780429029417
Khatibi T, Shahsavari A, Farahani A. Proposing a novel multi-instance learning model for tuberculosis recognition from chest X-ray images based on CNNs, complex networks, and stacked ensemble. Phys Eng Sci Med. 2021 Mar 1;44(1):291–311. https://doi.org/10.1007/s13246-021-00980-w
Hwa SKT, Hijazi MHA, Bade A, Yaakob R, Jeffree MS. Ensemble deep learning for tuberculosis detection using chest X-ray and Canny edge detected images. IAES International Journal of Artificial Intelligence. 2019 Dec 1;8(4):429–35. doi: https://doi.org/10.11591/ijai.v8.i4.pp429-435
Ayaz M, Shaukat F, Raja G. Ensemble learning-based automatic detection of tuberculosis in chest X-ray images using hybrid feature descriptors. Phys Eng Sci Med. 2021 Mar 1;44(1):183–94. https://doi.org/10.1007/s13246-020-00966-0
Wong A, Lee JRH, Rahmat-Khah H, Sabri A, Alaref A, Liu H. TB-Net: A Tailored, Self-Attention Deep Convolutional Neural Network Design for Detection of Tuberculosis Cases From Chest X-Ray Images. Front Artif Intell. 2022 Apr 7;5. doi: https://doi.org/10.3389/frai.2022.827299
Munadi K, Muchtar K, Maulina N, Pradhan B. Image Enhancement for Tuberculosis Detection Using Deep Learning. IEEE Access. 2020;8:217897–907. doi: https://doi.org/10.1109/ACCESS.2020.3041867
Mirugwe A, Lillian Tamale M, Nyirenda J. Improving Tuberculosis Detection in Chest X-Ray Images Through Transfer Learning and Deep Learning: Comparative Study of Convolutional Neural Network Architectures [Internet]. https://doi.org/10.2196/66029
Rajaraman S, Antani SK. Modality-Specific Deep Learning Model Ensembles Toward Improving TB Detection in Chest Radiographs. IEEE Access. 2020;8:27318–26. doi: https://doi.org/10.1109/access.2020.2971257
Rahman T, Khandakar A, Kadir MA, Islam KR, Islam KF, Mazhar R, et al. Reliable tuberculosis detection using chest X-ray with deep learning, segmentation, and visualization. IEEE Access. 2020;8:191586–601. doi: https://doi.org/10.48550/arXiv.2007.14895
Rajaraman S, Kim I, Antani SK. Detection and visualization of abnormality in chest radiographs using modality-specific convolutional neural network ensembles. PeerJ. 2020;2020(3). https://doi.org/10.7717/peerj.8693
Sahlol AT, Elaziz MA, Jamal AT, Damaševičius R, Hassan OF. A novel method for the detection of tuberculosis in chest radiographs using artificial ecosystem-based optimization of deep neural network features—symmetry (Basel). 2020 Jul 1;12(7). https://doi.org/10.3390/sym12071146
Win KY, Maneerat N, Hamamoto K, Sreng S. Hybrid learning of hand-crafted and deep-activated features using particle swarm optimization and optimized support vector machine for tuberculosis screening. Applied Sciences (Switzerland). 2020 Sep 1;10(17). https://doi.org/10.3390/app10175749
Hwa SKT, Bade A, Hijazi MHA, Jeffree MS. Tuberculosis detection using deep learning and contrast-enhanced canny edge-detected X-Ray images. IAES International Journal of Artificial Intelligence. 2020;9(4):713–20. http://doi.org/10.11591/ijai.v9.i4.pp713-720
Msonda P, Uymaz SA, Karaaǧaç SS. Spatial pyramid pooling in deep convolutional networks for automatic tuberculosis diagnosis. Traitement du signal. 2020 Dec 1;37(6):1075–84. https://doi.org/10.18280/ts.370620
Pasa F, Golkov V, Pfeiffer F, Cremers D, Pfeiffer D. Efficient Deep Network Architectures for Fast Chest X-Ray Tuberculosis Screening and Visualization. Sci Rep. 2019 Dec 1;9(1). https://doi.org/10.1038/s41598-019-42557-4
Devnath L, Luo S, Summons P, Wang D. Tuberculosis (TB) classification in chest radiographs using deep convolutional neural networks. https://doi.org/10.3389/fmed.2024.1290729
Santosh K, Allu S, Rajaraman S, Antani S. Advances in Deep Learning for Tuberculosis Screening using Chest X-rays: The Last 5 Years Review. J Med Syst. 2022 Nov 1;46(11). https://doi.org/10.1007/s10916-022-01870-8
Nafisah SI, Muhammad G. An Explainable Graph Neural Network for Harnessing Long-Range Dependencies in Tuberculosis Classifications in Chest X-Ray Images. Neural Comput Appl. 2024 Jan 1;36(1):111–31. https://doi.org/10.3390/diagnostics15243236
Venkatachalam C, Shah P. A Dual-Branch Deep Learning Framework Combining Xception and ResNet for Accurate Lung and Colon Cancer Detection. IEEE Access. 2025;13:131483–97. doi: https://ieeexplore.ieee.org/document/11081468/
Singh Bisht A, Ajay A, Karthik R. DeepCRC-Net: An Attention-Driven Deep Learning Network for Colorectal Cancer Classification Using Xception and Efficient Lightweight Local Feature Fusion Networks. IEEE Access. 2025;13:49362–74. https://doi:10.1109/ACCESS.2025.3550004
Liu L, Xia K. BTIS-Net: Efficient 3D U-Net for Brain Tumor Image Segmentation. IEEE Access. 2024;12:133392–405. doi: https://doi.org/10.1109/ACCESS.2024.3460797
Jain M, Shah A. Anomaly Detection Using Convolutional Neural Networks (CNN). International Journal of Advancements in Computational Technology. 2024;2:12–22. doi: https://doi.org/10.56472/25838628/IJACT-V2I3P102
Brima Y, Atemkeng M, Djiokap ST, Ebiele J, Tchakounté F. Transfer learning for the detection and diagnosis of types of pneumonia, including pneumonia induced by COVID-19, from chest X-ray images. doi. 2021;11(8):1480. https://doi.org/10.3390/diagnostics11081480
Ahmed MS, Rahman A, AlGhamdi F, AlDakheel S, Hakami H, AlJumah A, et al. Joint diagnosis of pneumonia, COVID-19, and tuberculosis from chest X-ray images: A deep learning approach. doi. 2023;13(15):2562. https://doi.org/10.3390/diagnostics13152562
Mwendo I, Gikunda P, Maina A. Deep transfer learning for detecting COVID-19, pneumonia, and tuberculosis using CXR images: A review. arXiv. 2023. Doi : https://arxiv.org/abs/2303.16754
Mabrouk A, Díaz Redondo RP, Dahou A, Elaziz MA, Kayed M. Pneumonia detection on chest X-ray images using an ensemble of deep convolutional neural networks. arXiv. 2023. Doi. https://arxiv.org/abs/2312.07965
Shahzad S, Sajeela, Shah N, Khan SA. Ensemble deep learning for multi-class chest X-ray classification: Robust detection of pneumonia and tuberculosis. Med Res Arch. 2025;13(11). Doi: https://doi.org/10.18103/mra.v13i11.7065
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Copyright (c) 2026 Abdul Rehman Khan Tareen, Muhammad Laiq Ur Rahman Shahid , Muhammad Hamza Zafar, Soban Abu Khifs , Furqan Shaukat

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