COVID-19 digital x-rays forgery classification model using deep learning

IAES International Journal of Artificial Intelligence (IJ-AI)
Vol. 12, No. 4, December 2023, pp. 1821~1827
ISSN: 2252-8938, DOI: 10.11591/ijai.v12.i4.pp1821-1827  1821
Journal homepage: http://ijai.iaescore.com
COVID-19 digital x-rays forgery classification model using
deep learning
Eman I. Abd El-Latif1
, Nour Eldeen Khalifa2
1
Department of Mathematics and Computer Science, Faculty of Science, Benha University, Benha, Egypt
2
Information Technology Department, Faculty of Computers and Artificial Intelligence, Cairo University, Giza, Egypt
Article Info ABSTRACT
Article history:
Received Aug 10, 2022
Revised Jan 12, 2023
Accepted Mar 10, 2023
Nowadays, the internet has become a typical medium for sharing digital
images through web applications or social media and there was a rise in
concerns about digital image privacy. Image editing software’s have prepared
it incredibly simple to make changes to an image's content without leaving
any visible evidence for images in general and medical images in particular.
In this paper, the COVID-19 digital x-rays forgery classification model
utilizing deep learning will be introduced. The proposed system will be able
to identify and classify image forgery (copy-move and splicing) manipulation.
Alexnet, Resnet50, and Googlenet are used in this model for feature extraction
and classification, respectively. Images have been tampered with in three
classes (COVID-19, viral pneumonia, and normal). For the classification of
(Forgery or no forgery), the model achieves 0.9472 in testing accuracy. For
the classification of (Copy-move forgery, splicing forgery, and no forgery),
the model achieves 0.8066 in testing accuracy. Moreover, the model achieves
0.796 and 0.8382 for 6 classes and 9 classes problems respectively.
Performance indicators like Recall, Precision, and F1 Score supported the
achieved results and proved that the proposed system is efficient for detecting
the manipulation in images.
Keywords:
COVID-19
Deep learning
Forgery detection
Image forgery
Medical image forgery
This is an open access article under the CC BY-SA license.
Corresponding Author:
Eman I. Abd El-Latif
Department of Mathematics and Computer Science, Faculty of Science, Benha University
Benha, Egypt
Email: eman.mohamed@fsc.bu.edu.eg
1. INTRODUCTION
There was widespread fear that the Severe Acute Respiratory Syndrome (SARS) virus had publishing
around the world by the end of 2003, owing to its alarmingly high infection rates in Asia and outbreaks in the
Middle East, as well as in nations such as Russia that had never seen it previously [1], [2]. This prompted
individuals to raise awareness of viruses, which have developed into important hazards in the twenty-first
century. The World Health Organization (WHO) designated 2019-nCov (COVID-19) as the coronavirus of the
year [3]. Several of the researches devoted to various problems connected to COVID-19 and solved by area of
computer science for example expecting COVID-19 symptoms with several kinds of pneumonia utilizing X-
rays scans [4], examining the function of new technologies in fighting the COVID-19 pandemic [5],
discovering the effects of coronavirus on power industry [6] and more. The majority of papers focus on
categorization and classification COVID-19 CT and X-ray images [7]–[10]. The purpose of this research is to
detect and classify different types of forgery in the COVID-19 dataset while the medical images were being
transmitted from one location to another.
Data transmission through the Internet has become important for numerous fields to share data such
as medicine, education, and digital forensics. Medical images can be transmitted and delivered through the

 ISSN: 2252-8938
Int J Artif Intell, Vol. 12, No. 4, December 2023: 1821-1827
1822
Internet to allow the diagnosis among medical staff and access to the history of the patient from any place.
There is various software used for changing the content of an image to create a forged one. This type of change
is called image forgery. Forged images display that the alteration in the image cannot be noticed by a visual
check. Therefore, checking the authentication of medical image content has become vital because any alteration
in the medical images can cause a wrong diagnosis.
There are two approaches employed in image forgery detection: active and passive approaches
[11], [12]. The active technique is categorized into two approaches: digital signature and watermarking. In
these techniques, a watermark and the signature are embedded into images during the pre-processing stage.
The most public types of passive approaches are image splicing and copy-move (CM). In CM technique, a
fragment of the image is copied and embedded into another area in the same image [13], [14]. The splicing
technique used fragments of different images and pastes them into another image [15], [16]. The existing
algorithms achieve acceptable performance in detecting passive image forgery. However, they cannot achieve
high detection accuracy with a small forgery region.
The proposed model's primary goal is to notice the splicing and copy-move manipulation in
COVID-19, viral pneumonia, and normal images. Deep transfer learning (DTL) presents an outstanding
performance in different computer vision problems included image classification [17], and semantic
segmentation [18]. Deep learning is a type of multi-layer neural network, in which every layer makes the output
from the preceding convolution layer available to the next layer as an input. It can extract complex features
from medical images automatically. Deep transfer learning (DTL) can be used on images used in medicine to
detect a CM and splicing forgery that the naked eye cannot see. Alexnet [19], Googlenet [20], and Resnet [21]
use learned features from training images and then classify the image. The rest of the paper is ordered. Section
2 presents the related work of forgery image detection. The proposed algorithm introduces in section 3. Section
4 contains the experimental results. The conclusions show in the final section.
2. RELATED WORKS
Various algorithms are proposed in this section to deal with image forgery. First, we will discuss the
numerous splicing techniques and then copy-move techniques. In [22], a method for noticing splicing forgery
depending on Haar wavelet transform (HWT) and uniform local binary pattern (ULBP) is presented. First, the
RGB image is transformed into the YCbCr model and then HWT is applied to produce the four sub-bands. For
every band, ULBP is computed. The final vector is concatenated from all sub-bands. For classification, support
vector machine (SVM) is used.
An algorithm in [23] is focused on convolutional neural network (CNN) and HWT is suggested to
identify the spliced images. HWT is applied after CNN is used to extract features. Finally, SVM is used to
classify images. An algorithm for detecting the alternating in the image is suggested in [24]. It is focused on
using LBP and discrete cosine transform (DCT). For each block in the chrominance component, LBP and DCT
are applied. For detection, SVM is used.
Ulutas et al. [25] presented a passive image algorithm to recognize the forged areas on medical
images. LBP rotation invariant and scale-invariant feature transform (SIFT) are applied to extract the key points
from the medical images. By matching the key points, forged regions are detected. In [26], CNN and error
level analysis (ELA) are used to discover forgery in COVID-19 medical images by detecting the noise pattern.
The algorithm achieves an accuracy of 92% for detecting image is forged or not.
The algorithm in [27] is used Markov features for extracting features from two domains: DWT and
LBP. Then, features are combined from both domains and fed to SVM for classification. Six benchmark
datasets are used to evaluate the algorithm. In [28], an algorithm is based on feature matching and CNN to
detect CM forgery. In CNN, many convolution and pooling layers are utilized for feature extraction and then
apply characterization among original and tampered images. To identify a CM forgery in [29], DWT and DCT
are used for feature extraction. Apply DWT to the image first, and then divide it into blocks. DCT is used for
all block, and the correlation coefficients are compared.
3. THE PROPOSED MODEL ARCHITECTURE
In this paper, a DLT approach is employed to identify the features of tampered regions. Splice and
copy-move are image forgery techniques that are difficult to tell apart from genuine ones. Many algorithms are
developed to detect image forgery. The existing algorithms suffer from low accuracy. Deep learning offers a
solution for digital image authentication because it extracts complex features from an image. The model relies
on three DTL models Alexnet, Googlenet, and Resnet50 to make features extraction and classification
processes at the same time as illustrated in Figure 1. These models need the least training time than other
pre-trained DLT models. Algorithm 1 shows the steps of the proposed model. The architecture of Alexnet is

Int J Artif Intell ISSN: 2252-8938 
COVID-19 digital x-rays forgery classification model using deep learning (Eman I. Abd El-Latif)
1823
consisting of eight layers, the first five layers are convolutional, and the remaining layers are fully connected.
After the first two convolutional layers, there is a max-pooling layer in size 3x3. The remainder of the
convolution layers is connected to fully connected layers. After every convolution layer, an activation function
is utilized called rectified linear unit (ReLU) nonlinearity. Different filters are used in each convolution layer.
For example, 96 kernels of size 11 × 11 × 3 are used in the first layer.
Figure 1. Proposed model architecture
ResNet stands for residual network, and it has many versions, Rsenet50 is one of these versions.
Resnet50 has used 50 neural network layers with 48 convolution layers and two pooling layers. It consists of
five stages every stage with a convolution layer and Individuality block. Each block contains three convolution
layers, and every Individuality block has three convolution layers.
There are three versions of Inception Networks, which are called inception versions 1, 2, and 3. The
GoogleNet or Inception V1 consists of 22 layers deep, 27 pooling layers, and 9 inception Layers and it is
proposed in 2014. The inception layer is a collection of all 1×1 convolutional layers, 3×3 convolutional layer,
and 5×5 convolutional layer to reduce the size of parameters in the network. The output of inception
is merged and sent to the next layer. At the end of the network, global average pooling is used to reduce the
number of trainable parameters.
Algorithm 1: The Suggested Model Algorithm
Input: COVID-19 Database and the Tampered Dataset
Output: Classification of the copy-move and splicing forgery of three classes {COVID-
19, Viral Pneumonia, Normal}
1. Copy Move (CM) forgery is created by copying and pasting a portion of an image from each
class.
2. A portion of each class is copied and pasted into the various images to produce splicing
forgery.
3. Download DTL models: Alexnet, Resnet50, and Googlenet
4. Train the proposed model with two, three, six, and nine classes
5. For every image in the dataset
6. Scale the input image to its default DTL aspects.
7. Provide the images to the DTL model for extraction and classification of features.
8. End
4. DATASET CHARACTERISTICS
The COVID-19 Radiography database utilized for training and testing is taken from the open-source
platform [30]. The dataset included three classes: 3,616 COVID-19, 10,129 normal and 1,345 viral pneumonia
images. The following operations are applied to the COVID-19, normal, and viral pneumonia images to create
the tampered images.
In the first operation, a region from each class of the original image is copied and pasted into the same
image to make a copy-move forgery. An area from the medical images is copied and pasted into other regions
in the different images to generate splicing forgery images. The dataset is available online on Mendeley data
[31]. the dataset consists of {COVID-19 2,000 images, CM COVID-19 2,000 images, S COVID-19 2,000
images, Viral Pneumonia 1,340 images, CM Viral Pneumonia 1,340 images, S Viral Pneumonia 850 images,
Normal 2,000 images, CM Normal 2,000 images, S Normal 2,000 images}. Figure 2 shows the original images

 ISSN: 2252-8938
1824
as shown in Figure 2(a), the result of copy-move as shown in Figure 2(b), and splicing forgery as shown in
Figure 2(c) of the COVID-19 image, viral Pneumonia, and normal respectively.
Figure 2. Sample images from the Radiography database, (a) original images, (b) Copy-move, and
(c) Splicing forgery techniques
5. EXPERIMENTAL RESULTS
This section presents the results of the conducted experiments and the metrics used to evaluate the
performance of the proposed model. For each experiment, a computer with 32 GB of RAM and an Intel Xeon
processor was utilized. The system contains an NVIDIA TITAN XP Graphics Card. The development of
experiments was GPU-specific to the software package MATLAB R2021b. The following hyperparameters
were applied to all experimental outcomes during the training and testing phases:
− Model DTL: Alexnet-Googlenet-Resnet50
− Training: 80%, Testing: 20%.
− Optimizer: Adamboost
− Momentum: 0.9
− Learning Rate: 0.001
− Epochs: 40
− Batch size: 32
− Early stopping: 5 epochs
5.1. Evaluation metrics
The experimental results of the algorithm are measured using different metrics such as accuracy,
precision, F-Measure, and recall. When dealing with data that is not balanced, precision and recall are better
suited for identifying a model's errors. The predictive performance of a model is summarized by the F-score,
which is the harmonic mean of precision and recall. The definitions are presented from (1) to (4),
Testing Accuracy =
TPos+TNeg
(TPos+FPos)+( TNeg+FNeg)
(1)
Precision =
TPos
(TPos+FPos)
(2)
Recall =
TruePos
(TPos+𝐹𝑁𝑒𝑔)
(3)
F1 Score = 2 ∗
Precision∗Recall
(Precision+Recall)
(4)
where TPos is the total number of true positive samples, TNeg is the total number of true negative samples,
FalsePos is the total number of false positive samples, and FalseNeg is the total number of false negative
samples from a confusion matrix.

1825
5.2. Results and discussion
Four classification experiments were conducted to evaluate the performance of the proposed model.
The first classification experiment includes two classes (Forgery or no forgery). Table 1 shows the
classification results obtained from Alexnet, Google net, and Resnet50. As shown in Table 1, Resnet50
achieves the highest accuracy possible in the recall, precision, F-score, and testing accuracy if it is compared
to the other DTL models.
Table 1. Testing accuracy and performance metrics for the first classification experiment (Forgery or
no forgery) using different DTL models
Recall Precision F Score Testing Accuracy
Alexnet 0.8955 0.9232 0.9091 0.9109
Googlenet 0.9222 0.9463 0.9341 0.9363
Resnet50 0.9347 0.9544 0.9445 0.9472
The second classification experiment was dedicated to three classes, and they are (Copy-move
forgery, splicing forgery, or no forgery). The testing accuracies are 80.66% in Resnet50, 77.73% in Googlenet,
and 66.96 % in Alexnet as shown in Table 2. The results proved the effectiveness of Resnet50 in detecting
forged images same as in the first classification experiment.
Table 2. Testing accuracy and performance metrics for the second classification experiment for 3 classes
(CM forgery, S forgery or no forgery) using different DTL models
Alexnet 0.6888 0.6616 0.6749 0.6696
Googlenet 0.7882 0.7732 0.7807 0.7773
Resnet50 0.8123 0.8045 0.8084 0.8066
To test the ability of the proposed model, different forgeries techniques for the different main classes
are proposed. The Third classification experiment was conducted on six classes, and they are {CM forgery in
COVID-19, splicing in COVID-19, CM forgery in Viral Pneumonia, splicing in Viral Pneumonia, CM forgery
in Normal, splicing in Normal} as presented in Table 3. The classification testing accuracy was 79.6% using
Resnet50 which is the highest testing accuracy possible.
Table 3. Testing accuracy and performance metrics for the third classification experiment for 6 classes using
different DTL models
Alexnet 0.7179 0.712 0.715 0.7072
Googlenet 0.7668 0.7598 0.7633 0.7607
Resnet50 0.7913 0.7864 0.7888 0.7960
The Fourth classification experiment was dedicated to classifying different nine classes, and they are
CM forgery in COVID-19, Splicing in COVID-19, COVID-19, CM forgery in Viral Pneumonia, splicing in
Viral Pneumonia, Viral Pneumonia, CM forgery in Normal, Splicing in Normal, Normal). In Table 4, the
testing accuracies were 83.82% in Resnet50, 77.16% in Googlenet, and 68.15 % in Alexnet. The results proved
the effectiveness of Resnet50 in detecting forged images same as in the first, second, and third classification
experiments.
Table 4. Testing accuracy and performance metrics for the fourth classification experiment for 9 classes
using different DTL models
Alexnet 0.6844 0.7003 0.6923 0.6815
Googlenet 0.7715 0.798 0.7846 0.7716
Resnet50 0.8304 0.8382 0.8343 0.8382

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6. CONCLUSION
Image splicing and copy-move forgery are well-known techniques in the forgery domain. The spliced
image was carried out by copying and pasting some portions from one image into other images. In this paper,
a proposed model for identifying two techniques in image forgery is proposed. To achieve good results, the
proposed algorithm used three DLTs that extract features from images. The selected dataset consisted of three
classes (COVID-19, Viral pneumonia, and Normal) class and we made two operations in images to generate
CM and splicing forgery. We used the difference between the normal, viral, and COVID-19 images to train the
model. The proposed model can efficiently identify image splicing and copy-move forgery of images. The
proposed algorithm achieved a relatively high detection accuracy of 94.72% of Resnet50 for the classification
of two classes. The model accomplished 80.66% in testing accuracy for three classes (Copy-move forgery,
splicing forgery, and no forgery). Moreover, the model achieves 79.60% and 83.82% for the 6 and 9 classes
classification respectively. Performance indicators such as recall, precision, and F1 Score supported the
obtained results and proved that the proposed model was efficient for detecting manipulation in digital medical
images.
Compliance with Ethical Standards:
Ethical statement: This material is the author's original work, which has not been previously published
elsewhere. The paper is not currently being considered for publication elsewhere.
Author contribution: All authors contributed to the study's conception and design. Material preparation was
performed by Eman Ibrahim. The first draft of the manuscript was written by Eman Ibrahim, and all authors
commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Data availability statement: The data that support the findings of this study are available from author Eman
Ibrahim, upon reasonable request.
Funding: There was no external funding for this research.
Conflict of interest: The corresponding author certifies that there is no conflict of interest on behalf of all
authors.
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BIOGRAPHIES OF AUTHORS
Eman I. Abd El-Latif received the M.Sc. and Ph.D. degree in computer science,
at Faculty of Science, Benha University, Egypt, in 2016 and 2020 respectively. She is
currently working a lecturer at computer science and mathematics department, Benha
University, Egypt. Her areas of research include Digital Forensics, Security (Encryption-
Steganography) and image processing. She can be contacted at email:
eman.mohamed@fsc.bu.edu.eg.
Nour Eldeen Khalifa received his B.Sc., M.Sc. and Ph.D. degree in 2006, 2009
and 2013 respectively, all from Cairo University, Faculty of Computers and Artificial
Intelligence, Cairo, Egypt. He also had a Professional M.Sc. Degree in Cloud Computing in
2018. He authored/coauthored more than 40 publications and 2 edited books. He had more
than 2000 citations. He reviewed several papers for international journals and conferences
including (Scientific Reports, IEEE IoT, Neural Computing, and Artificial Intelligence
Review). Currently, he is an associate professor at Faculty of Computers and Artificial
Intelligence, Cairo University. His research interests include wireless sensor networks,
cryptography, multimedia, network security, machine, and deep learning. He can be
contacted at email: nourmahmoud@cu.edu.eg.

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