{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T23:13:57Z","timestamp":1780355637108,"version":"3.54.1"},"reference-count":63,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004242","name":"Princess Nourah bint Abdulrahman University Researchers Supporting Project","doi-asserted-by":"publisher","award":["PNURSP2022R293"],"award-info":[{"award-number":["PNURSP2022R293"]}],"id":[{"id":"10.13039\/501100004242","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Sarcoidosis is frequently misdiagnosed as tuberculosis (TB) and consequently mistreated due to inherent limitations in radiological presentations. Clinically, to distinguish sarcoidosis from TB, physicians usually employ biopsy tissue diagnosis and blood tests; this approach is painful for patients, time-consuming, expensive, and relies on techniques prone to human error. This study proposes a computer-aided diagnosis method to address these issues. This method examines seven EfficientNet designs that were fine-tuned and compared for their abilities to categorize X-ray images into three categories: normal, TB-infected, and sarcoidosis-infected. Furthermore, the effects of stain normalization on performance were investigated using Reinhard\u2019s and Macenko\u2019s conventional stain normalization procedures. This procedure aids in improving diagnostic efficiency and accuracy while cutting diagnostic costs. A database of 231 sarcoidosis-infected, 563 TB-infected, and 1010 normal chest X-ray images was created using public databases and information from several national hospitals. The EfficientNet-B4 model attained accuracy, sensitivity, and precision rates of 98.56%, 98.36%, and 98.67%, respectively, when the training X-ray images were normalized by the Reinhard stain approach, and 97.21%, 96.9%, and 97.11%, respectively, when normalized by Macenko\u2019s approach. Results demonstrate that Reinhard stain normalization can improve the performance of EfficientNet -B4 X-ray image classification. The proposed framework for identifying pulmonary sarcoidosis may prove valuable in clinical use.<\/jats:p>","DOI":"10.3390\/s22103846","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T00:18:11Z","timestamp":1653005891000},"page":"3846","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Reliable Sarcoidosis Detection Using Chest X-rays with EfficientNets and Stain-Normalization Techniques"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3264-0179","authenticated-orcid":false,"given":"Nadiah","family":"Baghdadi","sequence":"first","affiliation":[{"name":"Nursing Management and Education Department, College of Nursing, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2201-7084","authenticated-orcid":false,"given":"Ahmed S.","family":"Maklad","sequence":"additional","affiliation":[{"name":"Computer Science Department, College of Computer Science and Engineering in Yanbu, Taibah University, Medina 42353, Saudi Arabia"},{"name":"Information Systems Department, Faculty of Computers and Artificial Intelligence, Beni-Suef University, Beni-Suif 62521, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3894-3293","authenticated-orcid":false,"given":"Amer","family":"Malki","sequence":"additional","affiliation":[{"name":"Computer Science Department, College of Computer Science and Engineering in Yanbu, Taibah University, Medina 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4388-1480","authenticated-orcid":false,"given":"Mohanad A.","family":"Deif","sequence":"additional","affiliation":[{"name":"Department of Bioelectronics, Modern University of Technology and Information (MTI University), Cairo 12055, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1159\/000457804","article-title":"Coexistent sarcoidosis and tuberculosis: A case report","volume":"93","author":"Carbonelli","year":"2017","journal-title":"Respiration"},{"key":"ref_2","unstructured":"World Health Organization (2013). 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