# Demystifying Deep Learning-based Brain Tumor Segmentation with 3D UNets and Explainable AI (XAI): A Comparative Analysis

arXiv: https://arxiv.org/abs/2510.07785 · HTML: https://mlsanity.com/paper/2510.07785/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 15 of its 46 references that are in the map.
- First posted on arXiv 9 Oct 2025.

## Builds on (most cited first, 15 of 15)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [ImageNet Large Scale Visual Recognition Challenge](https://mlsanity.com/paper/1409.0575/) (2014)
- [Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift](https://mlsanity.com/paper/1502.03167/) (2015)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [Group Normalization](https://mlsanity.com/paper/1803.08494/) (2018)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [Identifying the Best Machine Learning Algorithms for Brain Tumor Segmentation, Progression Assessment, and Overall Survival Prediction in the BRATS Challenge](https://mlsanity.com/paper/1811.02629/) (2018)
- [Attention Gated Networks: Learning to Leverage Salient Regions in Medical Images](https://mlsanity.com/paper/1808.08114/) (2018)
- [Efficient Deep Learning: A Survey on Making Deep Learning Models Smaller, Faster, and Better](https://mlsanity.com/paper/2106.08962/) (2021)
- [Learn To Pay Attention](https://mlsanity.com/paper/1804.02391/) (2018)
- [Brain tumor segmentation with self-ensembled, deeply-supervised 3D U-net neural networks: a BraTS 2020 challenge solution](https://mlsanity.com/paper/2011.01045/) (2020)
- [Soft-Attention Improves Skin Cancer Classification Performance](https://mlsanity.com/paper/2105.03358/) (2021)

## Abstract (arXiv)

The current study investigated the use of Explainable Artificial Intelligence (XAI) to improve the accuracy of brain tumor segmentation in MRI images, with the goal of assisting physicians in clinical decision-making. The study focused on applying UNet models for brain tumor segmentation and using the XAI techniques of Gradient-weighted Class Activation Mapping (Grad-CAM) and attention-based visualization to enhance the understanding of these models. Three deep learning models - UNet, Residual UNet (ResUNet), and Attention UNet (AttUNet) - were evaluated to identify the best-performing model. XAI was employed with the aims of clarifying model decisions and increasing physicians' trust in these models. We compared the performance of two UNet variants (ResUNet and AttUNet) with the conventional UNet in segmenting brain tumors from the BraTS2020 public dataset and analyzed model predictions with Grad-CAM and attention-based visualization. Using the latest computer hardware, we trained and validated each model using the Adam optimizer and assessed their performance with respect to: (i) training, validation, and inference times, (ii) segmentation similarity coefficients and loss functions, and (iii) classification performance. Notably, during the final testing phase, ResUNet outperformed the other models with respect to Dice and Jaccard similarity scores, as well as accuracy, recall, and F1 scores. Grad-CAM provided visuospatial insights into the tumor subregions each UNet model focused on while attention-based visualization provided valuable insights into the working mechanisms of AttUNet's attention modules. These results demonstrated ResUNet as the best-performing model and we conclude by recommending its use for automated brain tumor segmentation in future clinical assessments. Our source code and checkpoint are available at https://github.com/ethanong98/MultiModel-XAI-Brats2020