ALL diagnosis: can efficiency and transparency coexist? An explainble deep learning approach

Acute Lymphoblastic Leukemia (ALL) is a life-threatening malignancy characterized by its aggressive progression and detrimental effects on the hematopoietic system. Early and accurate diagnosis is paramount to optimizing therapeutic interventions and improving clinical outcomes. This study introduces a novel diagnostic framework that synergizes the EfficientNet-B7 architecture with Explainable Artificial Intelligence (XAI) methodologies to address challenges in performance, computational efficiency, and explainability. The proposed model achieves improved diagnostic performance, with accuracies exceeding 96% on the Taleqani Hospital dataset and 95.50% on the C-NMC-19 and Multi-Cancer datasets. Rigorous evaluation across multiple metrics-including Area Under the Curve (AUC), mean Average Precision (mAP), Accuracy, Precision, Recall, and F1-score-demonstrates the model's robustness and establishes its superiority over state-of-the-art architectures namely VGG-19, InceptionResNetV2, ResNet50, DenseNet50 and AlexNet . Furthermore, the framework significantly reduces computational overhead, achieving up to 40% faster inference times, thereby enhancing its clinical applicability. To address the opacity inherent in Deep learning (DL) models, the framework integrates advanced XAI techniques, including Gradient-weighted Class Activation Mapping (Grad-CAM), Class Activation Mapping (CAM), Local Interpretable Model-Agnostic Explanations (LIME), and Integrated Gradients (IG), providing transparent and explainable insights into model predictions. This fusion of high diagnostic precision, computational efficiency, and explainability positions the proposed framework as a transformative tool for ALL diagnosis, bridging the gap between cutting-edge AI technologies and practical clinical deployment.