What deep learning strategies best balance accuracy and interpretability in medical image segmentation for disease progression analysis?

Strategies in Deep Learning for Accurate and Interpretable Results in Medical Image Segmentation

Medical image segmentation demands strong accuracy and clinical credence. Black box models of deep learning may be barriers, but the following methods serve as bridging measures:

Explainable AI (XAI): Methods such as saliency maps, Grad-CAM, or prototype-based networks help make decisions more interpretable by being able to point to areas that lead to a prediction.

Uncertainty Quantification (UQ): Bayesian neural networks, Monte Carlo dropout, and ensembles offer voxel-level confidence predictions so that regions of model uncertainty can be indicated by healthcare specialists.

Hybrid Modeling: Mixing deep learning with knowledge in a particular domain (for example, priors in anatomy or physics-informed models) enforces the reasonableness of the segmentation results.

Attention Mechanisms and Transformers: Attention maps reveal the network’s attention and improve explainability while allowing good segmentation results to be achieved. rule-based post-processing: Adding morphological or size restrictions helps to ensure biologically realistic results and prevents illogical predictions.

Recommended approach: Combine high-performance backbone architectures such as U-Net or transformer models with XAI and uncertainty quantification techniques. Moreover, hybrid solutions or prototype explanations could be beneficial for further improving interpretation aspects without reducing model performance. Above all, this is still

 In general, no single strategy is perfect, so the best approach is a combination of explanatory AI (XAI) architectures and methods. 
Using hybrid architectures (e.g., modified U-Net or CNN-Transformer) to provide high segmentation accuracy.
Using XAI methods (especially Grad-CAM) to visualize where the models are focusing, allowing clinicians to track changes in lesion patterns over time.
Implementing BNNs (Bayesian neural networks) to quantify uncertainty, which can serve as an early indicator of a state change when the model becomes less "confident" in its predictions.

An explainable AI sounds nonsense to me. Malignant cell recognition should be translation and rotation invariant. Moreover, the operator and evaluator bias can also distort the decision.
The only practice to be recommended:
1) balanced data set (resampling),
2) using more (>7) performance indicator;  accuracy, selectivity, specificity, F1-score, etc.
3) ranking the classifiers according to these indicators, build their consensus,
4) Select the best model from the Pareto front by using multicriteria decision analysis (MCDA) by using e.g. Topsis, sum of ranking differences, VIKOR, etc.

Explainable AI or Atte tion based networks works well with CT or MRI images.