Explainable AI for Medical Imaging: A Taxonomy Based on Clinical Task Requirements

Authors

  • Ali Nadhim Kamber Ministry of Education Iraq, General Direction Of Vocational Education, Al-Najaf, Iraq Author
  • Hussein Alkaabi Ministry of Education Iraq, General Direction of Vocational Education, Al-Najaf, 54001, Iraq Author
  • Mohammed Al-Rekabi Department of Computer Engineering, College of Engineering, University of Al-Shatra, Author
  • Ali Kadhim Jasim Imam Ja‘far al Sadiq University – Maysan Branch, Computer Engineering Department, iraq Translator

DOI:

https://doi.org/10.62671/perfect.v2i2.115

Keywords:

Explainable AI (XAI), Medical Imaging, Clinical Decision Support, Taxonomy , Interpretability

Abstract

Explainable Artificial Intelligence (XAI) has emerged as a critical enabler for deploying AI-driven medical imaging systems where transparency, trust, and accountability are paramount. However, most current taxonomies of XAI methods categorize techniques based on algorithmic families (e.g., saliency maps, attribution methods), which often fail to reflect the practical requirements of clinical tasks. This paper proposes a novel task-centric taxonomy of XAI in medical imaging that aligns explanation techniques with four key clinical tasks: classification, detection, segmentation, and prognostic assessment. For each task, we analyze how different XAI methods enhance model interpretability, their suitability for clinical decision-making, and their limitations in real-world applications. Our taxonomy aims to provide a practical framework for researchers and practitioners to select appropriate XAI strategies tailored to the specific demands of medical imaging workflows. Furthermore, we highlight the current gaps in task-specific explainability and propose future research directions towards clinically meaningful, task-driven XAI solutions. This work serves as a step towards bridging the gap between technical XAI developments and the functional needs of clinical practice.

References

Jain, L., Singh, P.: A historical and qualitative analysis of different medical imaging techniques. International Journal of Computer Applications 107(15) (2014)

Razzak, M.I., Naz, S., Zaib, A.: Deep learning for medical image processing: Overview, challenges and the future. In: Classification in BioApps: Automation of Decision Making, pp. 323–350 (2017)

Jabbooree, A.I., Alkaabi, H., Kamber, A.N.: Facial Expression Recognition Using Fused Features: A Comparison of Deep and Machine Learning. J. Comput. Netw. Archit. High Perform. Comput. 7(3), 684–699 (2025)

Hua, D., Petrina, N., Young, N., Cho, J.G., Poon, S.K.: Understanding the factors influencing acceptability of AI in medical imaging domains among healthcare professionals: A scoping review. Artif. Intell. Med. 147, 102698 (2024)

Song, Y., Liu, Y., Lin, Z., Zhou, J., Li, D., Zhou, T., Leung, M.F.: Learning from AI-generated annotations for medical image segmentation. IEEE Trans. Consum. Electron. (2024)

Khan, M.M., Shah, N., Shaikh, N., Thabet, A., Belkhair, S.: Towards secure and trusted AI in healthcare: a systematic review of emerging innovations and ethical challenges. Int. J. Med. Inform. 195, 105780 (2025)

Minh, D., Wang, H.X., Li, Y.F., Nguyen, T.N.: Explainable artificial intelligence: a comprehensive review. Artif. Intell. Rev. 55(5), 3503–3568 (2022)

Fontes, M., De Almeida, J.D.S., Cunha, A.: Application of example-based explainable artificial intelligence (XAI) for analysis and interpretation of medical imaging: a systematic review. IEEE Access 12, 26419–26427 (2024)

Ahmed, S., Kaiser, M.S., Hossain, M.S., Andersson, K.: A comparative analysis of LIME and SHAP interpreters with explainable ML-based diabetes predictions. IEEE Access 13, 37370–37388 (2024)

Islam, S.M.S., Nasim, M.A.A., Hossain, I., Ullah, D.M.A., Gupta, D.K.D., Bhuiyan, M.M.H.: Introduction of medical imaging modalities. In: Data Driven Approaches on Medical Imaging, pp. 1–25. Springer, Cham (2023)

Najjar, R.: Redefining radiology: a review of artificial intelligence integration in medical imaging. Diagnostics 13(17), 2760 (2023)

Mohammed, A.A., Abdulwahhab, A.H., Ibraheem, I.K.: Detection Lung Nodules Using Medical CT Images Based on Deep Learning Techniques. Baghdad Sci. J. 22(5), 1596–1608 (2025)

Esmaeilzadeh, P.: Challenges and strategies for wide-scale artificial intelligence (AI) deployment in healthcare practices: A perspective for healthcare organizations. Artif. Intell. Med. 151, 102861 (2024)

Singh, S.K., Virdee, B.S., Aggarwal, S., Maroju, A.: Incorporation of XAI and deep learning in biomedical imaging: a review. Polytech. J. 15(1), 1–15 (2025)

Ashraf, K., Nawar, S., Hosen, M.H., Islam, M.T., Uddin, M.N.: Beyond the Black Box: Employing LIME and SHAP for Transparent Health Predictions with Machine Learning Models. In: 2024 International Conference on Advances in Computing, Communication, Electrical, and Smart Systems (iCACCESS), pp. 1–6. IEEE (2024)

Wollek, A., Graf, R., Čečatka, S., Fink, N., Willem, T., Sabel, B.O., Lasser, T.: Attention-based saliency maps improve interpretability of pneumothorax classification. Radiol. Artif. Intell. 5(2), e220187 (2023)

Kanglong, F.A.N., Ma, C., Peng, Y., Fang, Y., Ma, K.: Decision Rules are in the Pixels: Towards Pixel-level Evaluation of Saliency-based XAI Models. (Preprint)

Rguibi, Z., Hajami, A., Zitouni, D., Elqaraoui, A., Bedraoui, A.: Cxai: Explaining convolutional neural networks for medical imaging diagnostic. Electronics 11(11), 1775 (2022)

Guluwadi, S.: Enhancing brain tumor detection in MRI images through explainable AI using Grad-CAM with ResNet-50. BMC Med. Imaging 24(1), 1–19 (2024)

Sarp, S., Catak, F.O., Kuzlu, M., Cali, U., Kusetogullari, H., Zhao, Y., et al.: An XAI approach for COVID-19 detection using transfer learning with X-ray images. Heliyon 9(4) (2023)

Prasad Koyyada, S., Singh, T.P.: An explainable artificial intelligence model for identifying local indicators and detecting lung disease from chest X-ray images. Healthc. Anal. 4, 100206 (2023)

Avazov, K., Mirzakhalilov, S., Umirzakova, S., Abdusalomov, A., Cho, Y.I.: Dynamic focus on tumor boundaries: A lightweight U-Net for MRI brain tumor segmentation. Bioengineering 11(12), 1302 (2024)

Farrag, A., Gad, G., Fadlullah, Z.M., Fouda, M.M., Alsabaan, M.: An explainable AI system for medical image segmentation with preserved local resolution: Mammogram tumor segmentation. IEEE Access 11, 125543–125561 (2023)

Thiagarajan, J.J., Thopalli, K., Rajan, D., Turaga, P.: Training calibration-based counterfactual explainers for deep learning models in medical image analysis. Sci. Rep. 12(1), 597 (2022)

Akinsiku, A.M.: Literature Review on Explainable Artificial Intelligence (XAI): Techniques, Tools, and Applications. Tech-Sphere J. Pure Appl. Sci. 2(1) (2025)

Bibi, N., Courtney, J., McGuinness, K.: Enhancing brain disease diagnosis with XAI: a review of recent studies. ACM Trans. Comput. Healthc. 6(2), 1–35 (2025)

Phillips, V.: A counterintuitive approach to explainable AI in healthcare: balancing transparency, efficiency, and cost. AI Soc. (2025)

Saadoun, O.N., Allayith, R.A., Lafta, M.K., Shakir, K.H., Hussein, A.S., Al-Farouni, M., Shareef, H.: AI Deployment Susceptibility: Challenges in Clinical Decision-Aid Implementation. In: 2024 International Conference on IoT, Communication and Automation Technology (ICICAT), pp. 597–602. IEEE (2024)

Downloads

Published

2025-08-14

How to Cite

Kamber, A. N., Alkaabi, H., & Al-Rekabi, M. (2025). Explainable AI for Medical Imaging: A Taxonomy Based on Clinical Task Requirements. PERFECT: Journal of Smart Algorithms, 2(2), 72-77. https://doi.org/10.62671/perfect.v2i2.115

How to Cite

Kamber, A. N., Alkaabi, H., & Al-Rekabi, M. (2025). Explainable AI for Medical Imaging: A Taxonomy Based on Clinical Task Requirements. PERFECT: Journal of Smart Algorithms, 2(2), 72-77. https://doi.org/10.62671/perfect.v2i2.115