Accurate Recognition of Pneumonia and COVID-19 by Geometric Shape Normalization of Lung Region using Automatic Landmark Detection and Piecewise Affine Warping

Automated classification of pulmonary disease from chest radiographs is a widely studied application of machine learning in medical imaging. This paper presents a pilot study evaluating classical texture- and gradient-based feature representations for distinguishing COVID-19 from other forms of pneumonia using the publicly available COVID-19 Image Data Collection (668 posteroanterior/anteroposterior radiographs from 408 patients). Using histogram of oriented gradients (HOG) and gray-level co-occurrence matrix (GLCM) texture descriptors with classical classifiers (logistic regression, random forest, and support vector machine), evaluated under patient-level 5-fold stratified cross-validation to prevent data leakage, we obtain a best mean accuracy of 75.4% and AUC of 0.755, modestly exceeding the 71.6% majority-class baseline. We report these results transparently, including their limitations, and use them to motivate and scope a proposed multi-modal deep learning architecture -- combining convolutional and transformer-based encoders across imaging modalities -- as a direction for future work requiring access to larger, multi-institutional, ethically sourced datasets.

Deep-learning models can achieve strong chest X-ray (CXR) classification performance without establishing whether their predictions predominantly rely on pulmonary image content. This study evaluates pulmonary attribution containment as an anatomy-related reliability property distinct from diagnostic performance. We propose DBCA-SegNet-MGAP, a multi-task anatomy-guided CNN-Transformer framework that combines complementary feature representations through bidirectional cross-backbone attention, predicts a soft lung mask, and incorporates this anatomical prior directly into classification through Mask-Guided Adaptive Global Average Pooling (MGAP). Pulmonary attribution containment is quantified using the Anatomical Local Energy Ratio (ALR) and high-intensity cumulative ALR (cALR@0.9). Experiments were repeated across three training seeds using the COVID-19 Radiography Database for four-class internal testing and a locked Shenzhen-to-Montgomery protocol for zero-shot external tuberculosis testing. On COVID-19, the proposed model achieved a weighted F1 of $0.9615 \pm 0.0015$ and macro ROC-AUC of $0.9906 \pm 0.0007$. In an architecture-matched dual-bridge comparison, replacing conventional GAP with MGAP increased ALR from $0.3878 \pm 0.0098$ to $0.7086 \pm 0.0104$ and cALR@0.9 from $0.5265 \pm 0.0101$ to $0.9905 \pm 0.0018$, while weighted F1 remained essentially unchanged ($0.9618 \pm 0.0015$ vs. $0.9615 \pm 0.0015$). Under locked external transfer to Montgomery, ROC-AUC remained $0.9080 \pm 0.0043$ and pulmonary ALR remained $0.6466 \pm 0.0081$, whereas weighted F1 decreased to $0.7528 \pm 0.0080$ and ECE increased to $0.1683 \pm 0.0055$. These findings show that diagnostic discrimination, calibration, and pulmonary attribution containment are distinct model properties and support their joint evaluation under internal testing and external domain shift.

COVID-19 was a significant challenge that led to the loss of numerous lives daily. Not only a certain country was involved in this outbreak, but even the world has suffered because of the coronavirus. Imaging techniques using computed tomography (CT) and X-rays of the lungs are the most useful tools for the COVID-19 or any other pandemic disease screening process. Technology today has revolutionized the world by using artificial intelligence to replace manual processes with automated machines, which enable the system to imitate the human brain by making wise decisions based on experience. Motivated by this, our work proposes to use convolutional neural networks (CNN) based models for designing a computer-aided diagnosis (CAD) system that differentiates between COVID-19 and healthy lung pictures. We used two different sets of X-ray images of the lungs in addition to two different sets of CT scans and the classification is done using a variety of networks that have been pre-trained such as VGG (16, 19), Densenet (121), Resnet (50, 50 V2, 101 V2), Mobile net (V2), Xception Inception (V3, Resnet V2), Efficient net (B0) and Nasnet (Large). On the X-ray and CT image datasets, Resnet and VGG architecture have shown the ability to properly differentiate COVID-19 from normal images, with an average accuracy of 95 to 98 percent respectively. Our acquired results on the classification datasets are competitive and superior to previously reported findings in the literature.