Syed Taimoor Hussain Shah ¹ Syed Adil Hussain Shah ^1,2 Iqra Iqbal Khan ³ Atif Imran ⁴ Syed Baqir Hussain Shah ⁵ Atif Mehmood ⁶ Shahzad Ahmad Qureshi ⁷ Mudassar Raza ⁸ Angelo Di Terlizzi ² Marco Cavaglià ¹ Marco A. Deriu ^1*

• ¹ Polytechnic University of Turin, Turin, Italy
• ² GPI SpA, Trento, Trentino-Alto Adige/Südtirol, Italy
• ³ Bahauddin Zakariya University, Multan, Punjab, Pakistan
• ⁴ National University of Sciences and Technology (NUST), Islamabad, Islamabad, Pakistan
• ⁵ COMSATS University Islamabad, Wah Campus, Wah Cantt, Pakistan
• ⁶ Zhejiang Normal University, Jinhua, Zhejiang Province, China
• ⁷ Pakistan Institute of Engineering and Applied Sciences, Nilore, Islamabad, Islamabad, Pakistan
• ⁸ HITEC University, Taxila, Punjab, Pakistan

Detecting lung diseases in medical images can be quite challenging for radiologists. In some cases, even experienced experts may struggle with accurately diagnosing chest diseases, leading to potential inaccuracies due to complex or unseen biomarkers. This review paper delves into various datasets and machine learning techniques employed in recent research for lung disease classification, focusing on pneumonia analysis using chest X-ray images. We explore conventional machine learning methods, pretrained deep learning models, customized convolutional neural networks (CNNs), and ensemble methods. A comprehensive comparison of different classification approaches is presented, encompassing data acquisition, preprocessing, feature extraction, and classification using machine vision, machine and deep learning, and explainable-AI (XAI). Our analysis highlights the superior performance of transfer learning-based methods using CNNs and ensemble models/features for lung disease classification. In addition, our comprehensive review offers insights for researchers in other medical domains too who utilize radiological images. By providing a thorough overview of various techniques, our work enables the establishment of effective strategies and identification of suitable methods for a wide range of challenges. Currently, beyond traditional evaluation metrics, researchers emphasize the importance of XAI techniques in machine and deep learning models and their applications in classification tasks. This incorporation helps in gaining a deeper understanding of their decision-making processes, leading to improved trust, transparency, and overall clinical decision-making. Our comprehensive review serves as a valuable resource for researchers and practitioners seeking not only to advance the field of lung disease detection using machine learning and XAI but also from other diverse domains.