Papers › Benchmarking saliency methods for chest X-ray interpretation
Benchmarking saliency methods for chest X-ray interpretation
Adriel Saporta, Xiaotong Gui, Ashwin Agrawal, Anuj Pareek, Steven Q. H. Truong, Chanh D. T. Nguyen, Van-Doan Ngo, Jayne Seekins, Francis G. Blankenberg, Andrew Y. Ng, Matthew P. Lungren, Pranav Rajpurkar
Saliency methods, which produce heat maps that highlight the areas of the medical image that influence model prediction, are often presented to clinicians as an aid in diagnostic decision-making. However, rigorous investigation of the accuracy and reliability of these strategies is necessary before they are integrated into the clinical setting. In this work, we quantitatively evaluate seven saliency methods, including Grad-CAM, across multiple neural network architectures using two evaluation metrics. We establish the first human benchmark for chest X-ray segmentation in a multilabel classification set-up, and examine under what clinical conditions saliency maps might be more prone to failure in localizing important pathologies compared with a human expert benchmark. We find that (1) while Grad-CAM generally localized pathologies better than the other evaluated saliency methods, all seven performed significantly worse compared with the human benchmark, (2) the gap in localization performance between Grad-CAM and the human benchmark was largest for pathologies that were smaller in size and had shapes that were more complex, and (3) model confidence was positively correlated with Grad-CAM localization performance. Our work demonstrates that several important limitations of saliency methods must be addressed before we can rely on them for deep learning explainability in medical imaging.
Code
Repository list and official/mentioned flags are the archive's, frozen 2025-07-28. Reachability, where shown, is from one Syntology probe window (2026-09-16 to 2026-09-18); repositories not probed show nothing. GitHub stars are not tracked.
Code Syntology ran Syntology
Not run by Syntology. Nothing on this page verifies that the listed code works.
Tasks
Results from the paper archive 2025-07-28
No leaderboard rows for this paper in the archive.
Report a problem or propose a change · a person checks every report against the paper or source before anything changes; decisions are listed on /corrections