Improved Segmentation of Polyps and Visual Explainability Analysis

Abstract

Colorectal cancer (CRC) remains one of the leading causes of cancer-related morbidity and mortality worldwide, with gastrointestinal (GI) polyps serving as critical precursors according to the World Health Organization (WHO). Early and accurate segmentation of polyps during colonoscopy is essential for reducing CRC progression, yet manual delineation is labor-intensive and prone to observer variability. Deep learning methods have demonstrated strong potential for automated polyp analysis, but their limited interpretability remains a barrier to clinical adoption. In this study, we present PolypSeg-GradCAM, an explainable deep learning framework that integrates a U-Net architecture with a pre-trained ResNet-34 backbone and Gradient-weighted Class Activation Mapping (Grad-CAM) for transparent polyp segmentation. To ensure rigorous benchmarking, the model was trained and evaluated using 5-Fold Cross-Validation on the Kvasir-SEG dataset of 1,000 annotated endoscopic images. Experimental results show a mean Dice coefficient of 0.8902 +/- 0.0125, a mean Intersection-over-Union (IoU) of 0.8023, and an Area Under the Receiver Operating Characteristic Curve (AUC-ROC) of 0.9722. Advanced quantitative analysis using an optimal threshold yielded a Sensitivity of 0.9058 and Precision of 0.9083. Additionally, Grad-CAM visualizations confirmed that predictions were guided by clinically relevant regions, offering insight into the model's decision-making process. This study demonstrates that integrating segmentation accuracy with interpretability can support the development of trustworthy AI-assisted colonoscopy tools.