Explainable Artificial Intelligence Driven Segmentation for Cervical Cancer Screening

Cervical cancer remains an important global health challenge among women. Early and accurate identification of abnormal cervical cells is crucial for effective treatment and improved survival rates. This paper addresses the development of a novel weakly supervised segmentation framework that combines binary classification, Explainable Artificial Intelligence (XAI) techniques, and GraphCut to automate cervical cancer screening. Unlike traditional segmentation methods that rely on pixel-level annotations of medical images, which are costly, laborious, and require expertise in medical imaging, our approach leverages classification-driven insights to segment the nucleus, cytoplasm, and background regions. A key innovation of our framework is the use of XAI techniques such as Grad-CAM++ and LRP combined with GraphCut, to enable annotation-free segmentation using only classification-level labels. This represents a pioneering application of explainability techniques in the context of cervical cancer screening. Among the classification models explored, including fine-tuned variants of VGGNet and XceptionNet, VGG16-Adapted128 achieved the highest performance, marked by an accuracy of 0.94, precision of 0.94, recall of 0.94, and an F1 score of 0.94. This novel segmentation framework employed LRP and GradCAM++ as XAI techniques to gain insight into the decision-making process of classification models, with GradCAM++ demonstrating greater effectiveness. The performance of these XAI methods was assessed through both visual inspection and quantitative metrics, including entropy and pixel flipping. This innovative approach to segmentation is formally introduced through two algorithms detailed in this paper. The weakly supervised segmentation framework achieved a Dice Similarity Coefficient (DSC) of 62.05% and an Intersection over Union (IoU) of 61.89%. In addition, it has received high satisfaction ratings from expert evaluations and has been seamlessly integrated into a user-friendly Web application, offering clinicians a transparent and reliable tool to improve the precision of decision-making in the detection of cervical cancer. Although this work represents an early step, it lays a strong foundation for advancing XAI-driven, weakly supervised segmentation techniques in medical imaging, particularly in resource-constrained cervical cancer screening contexts.