Towards Evaluating Explanations of Vision Transformers for Medical Imaging
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Abstract (arXiv)
As deep learning models increasingly find applications in critical domains such as medical imaging, the need for transparent and trustworthy decision-making becomes paramount. Many explainability methods provide insights into how these models make predictions by attributing importance to input features. As Vision Transformer (ViT) becomes a promising alternative to convolutional neural networks for image classification, its interpretability remains an open research question. This paper investigates the performance of various interpretation methods on a ViT applied to classify chest X-ray images. We introduce the notion of evaluating faithfulness, sensitivity, and complexity of ViT explanations. The obtained results indicate that Layerwise relevance propagation for transformers outperforms Local interpretable model-agnostic explanations and Attention visualization, providing a more accurate and reliable representation of what a ViT has actually learned. Our findings provide insights into the applicability of ViT explanations in medical imaging and highlight the importance of using appropriate evaluation criteria for comparing them.
Key facts. Cited by 23 papers in the map (data through 14 Oct 2026). Builds on 26 of its 37 references that are in the map. First posted on arXiv 12 Apr 2023.
Builds on
26 of 37 references.
References · 26
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14 more
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Citing papers per year: 2023: 4; 2024: 7; 2025: 6; 2026: 6.
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- 2023Adversarial attacks and defenses in explainable artificial intelligence: A surveycited by 48
- 2025Prisma: An Open Source Toolkit for Mechanistic Interpretability in Vision and Videocited by 21
- 2024Medical Slice Transformer: Improved Diagnosis and Explainability on 3D Medical Images with DINOv2cited by 13
- 2023Explainability of Vision Transformers: A Comprehensive Review and New Perspectivescited by 12
- 2025Evaluating Visual Explanations of Attention Maps for Transformer-based Medical Imagingcited by 7
- 2024Aggregated Attributions for Explanatory Analysis of 3D Segmentation Modelscited by 5
- 2025Evaluating the Explainability of Vision Transformers in Medical Imagingcited by 4
- 2026DAVE: Distribution-aware Attribution via ViT Gradient Decompositioncited by 4
- 2023Be Careful When Evaluating Explanations Regarding Ground Truthcited by 3
- 2024PM2: A New Prompting Multi-modal Model Paradigm for Few-shot Medical Image Classificationcited by 3
- 2024Revisiting FunnyBirds evaluation framework for prototypical parts networkscited by 2
- 2024CNN-based explanation ensembling for dataset, representation and explanations evaluationcited by 1
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- 2023DXAI: Explaining Classification by Image Decompositioncited by 0
- 2024Learning to Project for Cross-Task Knowledge Distillationcited by 0
- 2024DFE-IANet: A Method for Polyp Image Classification Based on Dual-domain Feature Extraction and Interaction Attentioncited by 0
- 2025PiPViT: Patch-based Visual Interpretable Prototypes for Retinal Image Analysiscited by 0
- 2025Topological Conditioning for Mammography Models via a Stable Wavelet-Persistence Vectorizationcited by 0
- 2026Uncertainty-Calibrated Explainable Artificial Intelligence for Fetal Ultrasound Plane Classification: A Systematic Reviewcited by 0
- 2026Med-SegLens: Latent-Level Model Diffing for Interpretable Medical Image Segmentationcited by 0
- 2026MedConcept: Unsupervised Concept Discovery for Interpretability in Medical VLMscited by 0
- 2026FZ-VLM: A Two Stage Florence-Zephyr Vision Language Model Framework for Pulmonary Nodule Characterization and Clinical Decision Makingcited by 0
- 2026Bridging Human and Model Attention: Explainability Analysis of CNN, Mamba, and ViT Architectures with Gaze-Based Validationcited by 0
- 2026Bridging Human and Model Attention: Explainability Analysis of CNN, Mamba, and ViT Architectures with Gaze-Based Validation8 Oct 2026
- 2026FZ-VLM: A Two Stage Florence-Zephyr Vision Language Model Framework for Pulmonary Nodule Characterization and Clinical Decision Making15 Aug 2026
- 2026MedConcept: Unsupervised Concept Discovery for Interpretability in Medical VLMs13 Apr 2026
- 2026Med-SegLens: Latent-Level Model Diffing for Interpretable Medical Image Segmentation11 Feb 2026
- 2026DAVE: Distribution-aware Attribution via ViT Gradient Decomposition6 Feb 2026
- 2026Uncertainty-Calibrated Explainable Artificial Intelligence for Fetal Ultrasound Plane Classification: A Systematic Review2 Jan 2026
- 2025Topological Conditioning for Mammography Models via a Stable Wavelet-Persistence Vectorization10 Dec 2025
- 2025Evaluating the Explainability of Vision Transformers in Medical Imaging13 Oct 2025
- 2025X-SiT: Inherently Interpretable Surface Vision Transformers for Dementia Diagnosis25 Jun 2025
- 2025PiPViT: Patch-based Visual Interpretable Prototypes for Retinal Image Analysis12 Jun 2025
- 2025Prisma: An Open Source Toolkit for Mechanistic Interpretability in Vision and Video28 Apr 2025
- 2025Evaluating Visual Explanations of Attention Maps for Transformer-based Medical Imaging12 Mar 2025
11 more
- 2024Medical Slice Transformer: Improved Diagnosis and Explainability on 3D Medical Images with DINOv224 Nov 2024
- 2024Revisiting FunnyBirds evaluation framework for prototypical parts networks21 Aug 2024
- 2024DFE-IANet: A Method for Polyp Image Classification Based on Dual-domain Feature Extraction and Interaction Attention30 Jul 2024
- 2024Aggregated Attributions for Explanatory Analysis of 3D Segmentation Models23 Jul 2024
- 2024CNN-based explanation ensembling for dataset, representation and explanations evaluation16 Apr 2024
- 2024PM2: A New Prompting Multi-modal Model Paradigm for Few-shot Medical Image Classification13 Apr 2024
- 2024Learning to Project for Cross-Task Knowledge Distillation21 Mar 2024
- 2023DXAI: Explaining Classification by Image Decomposition30 Dec 2023
- 2023Explainability of Vision Transformers: A Comprehensive Review and New Perspectives12 Nov 2023
- 2023Be Careful When Evaluating Explanations Regarding Ground Truth8 Nov 2023
- 2023Adversarial attacks and defenses in explainable artificial intelligence: A survey6 Jun 2023
- 2024Learning to Project for Cross-Task Knowledge Distillation21 Mar 2024
- 2023Adversarial attacks and defenses in explainable artificial intelligence: A surveycited by 48
- 2024Medical Slice Transformer: Improved Diagnosis and Explainability on 3D Medical Images with DINOv2cited by 13
- 2023Explainability of Vision Transformers: A Comprehensive Review and New Perspectivescited by 12
- 2025Evaluating Visual Explanations of Attention Maps for Transformer-based Medical Imagingcited by 7
- 2024Aggregated Attributions for Explanatory Analysis of 3D Segmentation Modelscited by 5
- 2025Evaluating the Explainability of Vision Transformers in Medical Imagingcited by 4
- 2026DAVE: Distribution-aware Attribution via ViT Gradient Decompositioncited by 4
- 2023Be Careful When Evaluating Explanations Regarding Ground Truthcited by 3
- 2024PM2: A New Prompting Multi-modal Model Paradigm for Few-shot Medical Image Classificationcited by 3
- 2024Revisiting FunnyBirds evaluation framework for prototypical parts networkscited by 2
- 2024CNN-based explanation ensembling for dataset, representation and explanations evaluationcited by 1
- 2025X-SiT: Inherently Interpretable Surface Vision Transformers for Dementia Diagnosiscited by 1
12 most cited of 18 All 18 (JSON)
- 2026Med-SegLens: Latent-Level Model Diffing for Interpretable Medical Image Segmentation11 Feb 2026
- 2026DAVE: Distribution-aware Attribution via ViT Gradient Decomposition6 Feb 2026
- 2026Uncertainty-Calibrated Explainable Artificial Intelligence for Fetal Ultrasound Plane Classification: A Systematic Review2 Jan 2026
- 2025Topological Conditioning for Mammography Models via a Stable Wavelet-Persistence Vectorization10 Dec 2025
- 2025Evaluating the Explainability of Vision Transformers in Medical Imaging13 Oct 2025
- 2025X-SiT: Inherently Interpretable Surface Vision Transformers for Dementia Diagnosis25 Jun 2025
- 2025PiPViT: Patch-based Visual Interpretable Prototypes for Retinal Image Analysis12 Jun 2025
- 2025Evaluating Visual Explanations of Attention Maps for Transformer-based Medical Imaging12 Mar 2025
- 2024Medical Slice Transformer: Improved Diagnosis and Explainability on 3D Medical Images with DINOv224 Nov 2024
- 2024Revisiting FunnyBirds evaluation framework for prototypical parts networks21 Aug 2024
- 2024DFE-IANet: A Method for Polyp Image Classification Based on Dual-domain Feature Extraction and Interaction Attention30 Jul 2024
- 2024Aggregated Attributions for Explanatory Analysis of 3D Segmentation Models23 Jul 2024
12 newest of 18 All 18 (JSON)