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Demystifying Artificial Intelligence: A Systematic Review of Explainable Artificial Intelligence in Medical Imaging

Fayaz M, Hagsong K, Danish S, Dang LM, Sadeghi-Niaraki A, Moon H

Sensors (Basel, Switzerland), 2026

2 citations

Abstract

This comprehensive literature review explores the latest advancements in explainable artificial intelligence (XAI) techniques within the field of medical imaging (MI). Over the past decade, machine learning (ML) and deep learning (DL) technologies have made significant strides in healthcare, enabling advancements in tasks such as disease diagnosis, medical image segmentation, and the detection of various medical conditions. However, despite these successes, the widespread adoption of AI-driven tools in clinical practice remains slow, primarily due to the "black-box" nature of many AI models. These models make decisions without transparent reasoning, which poses significant barriers in critical medical and legal environments, where accountability and trust are paramount. This review investigates various XAI methods, focusing on both intrinsic and post-hoc techniques, to evaluate their potential in addressing these challenges. The paper examines how XAI can enhance the transparency of healthcare algorithms, thereby fostering greater trust and confidence among clinicians, patients, and regulators. Key challenges faced by XAI in healthcare, such as limited interpretability, computational complexity, and the absence of standardized evaluation frameworks, are discussed in detail. Furthermore, this work highlights existing gaps in the literature, including the lack of detailed comparative analyses of specific XAI techniques, especially in terms of their mathematical foundations and…

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