A Systematic Study of Deep Learning Models and xAI Methods for Region-of-Interest Detection in MRI Scans

Magnetic Resonance Imaging (MRI) is an essential diagnostic tool for assessing knee injuries. However, manual interpretation of MRI slices remains time-consuming and prone to inter-observer variability. This study presents a systematic evaluation of various deep learning architectures combined with explainable AI (xAI) techniques for automated region of interest (ROI) detection in knee MRI scans. We investigate both supervised and self-supervised approaches, including ResNet50, InceptionV3, Vision Transformers (ViT), and multiple U-Net variants augmented with multi-layer perceptron (MLP) classifiers. To enhance interpretability and clinical relevance, we integrate xAI methods such as Grad-CAM and Saliency Maps. Model performance is assessed using AUC for classification and PSNR/SSIM for reconstruction quality, along with qualitative ROI visualizations. Our results demonstrate that ResNet50 consistently excels in classification and ROI identification, outperforming transformer-based models under the constraints of the MRNet dataset. While hybrid U-Net + MLP approaches show potential for leveraging spatial features in reconstruction and interpretability, their classification performance remains lower. Grad-CAM consistently provided the most clinically meaningful explanations across architectures. Overall, CNN-based transfer learning emerges as the most effective approach for this dataset, while future work with larger-scale pretraining may better unlock the potential of transformer models.