Faculty, Staff and Student Publications

Language

English

Publication Date

1-1-2026

Journal

Frontiers in Endocrinology

DOI

10.3389/fendo.2026.1869015

PMID

42523658

PMCID

PMC13407100

PubMedCentral® Posted Date

7-14-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Introduction: Accurate detection of gastrointestinal diseases from endoscopic images remains challenging due to substantial inter-class similarity, intra-class variability, and heterogeneous lesion presentation. While convolutional neural networks (CNNs) effectively capture fine mucosal textures, their limited receptive field restricts global contextual reasoning. Conversely, transformer architectures model long-range dependencies but may underrepresent localized structural detail.

Methods: This study proposes a dual-branch hybrid transformer framework that integrates global token-level reasoning from ViT-L/32 with hierarchical spatial modeling from MaxViT-L. An adaptive gated fusion mechanism is introduced to dynamically regulate the relative contribution of local and global representations on a per-sample basis, enabling content-aware cross-scale integration. The model was evaluated on a multi-class gastrointestinal endoscopic dataset using comprehensive quantitative metrics, class-wise analysis, ablation studies, confidence interval estimation, and statistical validation. Post-hoc explainability was further investigated using multiple complementary XAI techniques.

Results: The proposed framework demonstrated consistently high accuracy, sensitivity, specificity, and area under the ROC curve across eight gastrointestinal disease categories, outperforming several state-of-the-art transformer and hybrid architectures. The XAI analyses further confirmed lesion-focused activation consistency and stable decision-making.

Discussion: The findings indicate that adaptive local-global feature integration through gated fusion enhances both diagnostic performance and interpretability, supporting the potential of hybrid transformer architectures for reliable computer-aided gastrointestinal disease classification.

Keywords

Gastrointestinal Diseases, Humans, Convolutional Neural Networks, Endoscopy, Gastrointestinal, Image Interpretation, Computer-Assisted, Neural Networks, Computer, adaptive gated fusion, endoscopic image classification, explainable AI, gastrointestinal disease detection, hybrid transformer architecture, vision transformer

Published Open-Access

yes

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