Momentum-Anchored Multi-Scale Fusion Model for Long-Tailed Chest X-Ray Classification

Chest X-ray multi-label classification is a core task in intelligent medical imaging diagnosis. However, real clinical data often exhibit extreme long-tailed distributions, leading to degraded performance on rare diseases in tail classes. This issue is not only driven by data scarcity but also by two intrinsic factors:1) attenuation of tail-class lesion representations under complex anatomical backgrounds, and 2) dominance of head classes in modeling label co-occurrence relationships. To address these challenges, we propose TRCGL-Net. First, a learnable text-guided conditional diffusion model is employed to generate high-quality tail-class chest X-ray image samples under disease semantic constraints, improving data diversity and realism of rare disease patterns while alleviating class imbalance and preserving pathology-consistent semantics.Second, a channel reweighting mechanism is introduced to perform feature recalibration by emphasizing disease-relevant feature channels, thereby improving feature discriminability under long-tailed distributions.A class-aware attention mechanism is further applied to generate class-specific attention maps, enabling the model to localize disease-relevant regions and focus on fine-grained lesion areas.Finally, a graph convolution network based on label co occurrence is introduced to establish an information propagation mechanism among categories. Experiments on the PadChest dataset show that the proposed method achieves a tail-class mAP of 0.4904, an overall mAP of 0.4408, and an mAUC of 0.8989, outperforming state-of-the-art methods. TRCGL-Net effectively improves recognition performance for rare diseases under long-tailed distributions and mitigates the impact of extreme class imbalance in chest X-ray multi-label classification.

Chest radiography is a widely used imaging modality for thoracic disease diagnosis, yet its conventional interpretation remains time-consuming and heavily dependent on expert knowledge. While deep learning has improved diagnostic efficiency through automated feature extraction, challenges such as class imbalance and the localization of multiple co-existing pathologies remain unsolved. In this paper, inspired by the strength of Convolutional Block Attention Module (CBAM) in feature refinement and the capability of CNN blocks in feature extraction, we propose a strategy to integrate CBAM into traditional CNN blocks to enhance performance in multi-label classification tasks. Our method achieves a mean AUC of 0.8695 on ChestXray14 dataset, outperforming several state-of-the-art baselines.Our source code is available at: https://github.com/NNNguyenDuyyy/FETC_CBAM_Enhanced_CNN.git

Automated chest X-ray classification remains challenging due to severe class imbalance, co-occurring pathologies, and the loss of localized features in conventional architectures. To address these, we propose an explainable hierarchical multi-view ensemble framework for the robust classification of 14 thoracic pathologies. The framework employs view-specific training by independently modeling frontal and lateral radiographs using an ensemble of five complementary convolutional neural networks. Replacing global average pooling, a multi-scale feature fusion strategy augmented with Convolutional Block Attention Modules (CBAM) preserves fine-grained intermediate representations while emphasizing high-level pathology-specific semantic features. To mitigate positive-negative imbalance and varying inter-class difficulty, models are optimized using a novel hybrid objective combining Asymmetric Loss with Adaptive Focal Loss. Beyond simple probability averaging, the framework incorporates a hierarchical meta-learning strategy where test-time augmentation (TTA) predictions and cross-model uncertainty measures are integrated into Level-1 gradient-boosting meta-learners (XGBoost, LightGBM, and CatBoost), followed by Level-2 stacking with optimized alpha blending. Evaluated on a large-scale CheXpert-style dataset, the framework achieves state-of-the-art macro-average AUROC scores of 0.9319 for frontal and 0.9154 for lateral radiographs. Furthermore, comprehensive explainability analysis using seven post-hoc attribution techniques demonstrates strong anatomical consistency and clinically meaningful decision localization. By integrating architectural diversity, multi-scale attention, hierarchical meta-learning, and rigorous explainability, the proposed framework provides a transparent, highly accurate, and clinically practical computer-aided diagnosis system for thoracic disease classification.