Breaking Diagnostic Barriers: Vision Transformers Redefine Monkeypox Detection.

The global spread of Monkeypox (Mpox) has highlighted the urgent need for rapid, accurate diagnostic tools. Traditional methods like polymerase chain reaction (PCR) are resource-intensive, while skin image-based detection offers a promising alternative. This study evaluates the effectiveness of vision transformers (ViTs) for automated Mpox detection. By fine-tuning a pre-trained ViT model on an Mpox lesion image dataset, a robust ViT-based transfer learning (TL) model was created. Performance was assessed relative to convolutional neural network (CNN)-based TL models and ViT models trained from scratch across key metrics: accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC). Furthermore, a transferability measure was utilized to assess the effectiveness of feature transfer to Mpox images. The results show that the ViT model outperformed a CNN, achieving an AUC of 0.948 and an accuracy of 0.942 with a -value of less than 0.05 across all metrics, highlighting its potential for accurate and scalable Mpox detection. Moreover, the ViT models yielded a better hypothesis margin-based transferability measure, highlighting its effectiveness in transferring useful learning weights to Mpox images. Gradient-weighted Class Activation Mapping (Grad-CAM) visualizations also confirmed that the ViT model attends to clinically relevant features, supporting its interpretability and reliability for diagnostic use. The results from this study suggest that ViT offers superior accuracy, making it a valuable tool for Mpox early detection in field settings, especially where conventional diagnostics are limited. This approach could support faster outbreak response and improved resource allocation in public health systems.