Comparative Analysis of Deep Learning Architectures for Multi-Disease Classification of Single-Label Chest X-rays
It addresses the problem of improving diagnostic accuracy for pulmonary and cardiac disorders in healthcare settings with radiologist shortages, though it is incremental as it systematically compares existing methods on a new dataset.
This study compared seven deep learning architectures for classifying five chest diseases from X-rays, finding that all exceeded 90% accuracy, with ConvNeXt-Tiny achieving the highest at 92.31% accuracy and 95.70% AUROC, while MobileNetV2 was the most efficient with 3.5M parameters and 90.42% accuracy.
Chest X-ray imaging remains the primary diagnostic tool for pulmonary and cardiac disorders worldwide, yet its accuracy is hampered by radiologist shortages and inter-observer variability. This study presents a systematic comparative evaluation of seven deep learning architectures for multi-class chest disease classification: ConvNeXt-Tiny, DenseNet121, DenseNet201, ResNet50, ViT-B/16, EfficientNetV2-M, and MobileNetV2. A balanced dataset of 18,080 chest X-ray images spanning five disease categories (Cardiomegaly, COVID-19, Normal, Pneumonia, and Tuberculosis) was constructed from three public repositories and partitioned at the patient level to prevent data leakage. All models were trained under identical conditions using ImageNet-pretrained weights, standardized preprocessing, and consistent hyperparameters. All seven architectures exceeded 90% test accuracy. ConvNeXt-Tiny achieved the highest performance (92.31% accuracy, 95.70% AUROC), while MobileNetV2 emerged as the most parameter-efficient model (3.5M parameters, 90.42% accuracy, 94.10% AUROC), completing training in 48 minutes. Tuberculosis and COVID-19 classification was near-perfect (AUROC >= 99.97%) across all architectures, while Normal, Cardiomegaly, and Pneumonia presented greater challenges due to overlapping radiographic features. Grad-CAM visualizations confirmed clinically consistent attention patterns across disease categories. These findings demonstrate that high-accuracy multi-disease chest X-ray classification is achievable without excessive computational resources, with important implications for AI-assisted diagnosis in both resource-rich and resource-constrained healthcare settings.