{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:34:28Z","timestamp":1760060068793,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\u2014Fundac\u00e3o para a Ci\u00eancia e a Tecnologia","award":["2022.13770.BD"],"award-info":[{"award-number":["2022.13770.BD"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Applied Sciences"],"abstract":"<jats:p>Medical imaging is vital for diagnosing and treating colorectal cancer (CRC), a leading cause of mortality. Classifying colorectal polyps and CRC precursors remains challenging due to operator variability and expertise dependence. Deep learning (DL) models show promise in polyp classification but face adoption barriers due to their \u2018black box\u2019 nature, limiting interpretability. This study presents an example-based explainable artificial intehlligence (XAI) approach using Pix2Pix to generate synthetic polyp images with controlled size variations and LIME to explain classifier predictions visually. EfficientNet and Vision Transformer (ViT) were trained on datasets of real and synthetic images, achieving strong baseline accuracies of 94% and 96%, respectively. Image quality was assessed using PSNR (18.04), SSIM (0.64), and FID (123.32), while classifier robustness was evaluated across polyp sizes. Results show that Pix2Pix effectively controls image attributes like polyp size despite limitations in visual fidelity. LIME integration revealed classifier vulnerabilities, underscoring the value of complementary XAI techniques. This enhances DL model interpretability and deepens understanding of their behaviour. The findings contribute to developing explainable AI tools for polyp classification and CRC diagnosis. Future work will improve synthetic image quality and refine XAI methodologies for broader clinical use.<\/jats:p>","DOI":"10.3390\/app15158467","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:29:02Z","timestamp":1753885742000},"page":"8467","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Controlled Variation Approach for Example-Based Explainable AI in Colorectal Polyp Classification"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3417-0715","authenticated-orcid":false,"given":"Miguel Filipe","family":"Fontes","sequence":"first","affiliation":[{"name":"Institute for Systems and Computer Engineering, Technology and Science, 4200-465 Porto, Portugal"},{"name":"School of Sciences and Technology, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"}]},{"given":"Alexandre Henrique","family":"Neto","sequence":"additional","affiliation":[{"name":"Institute for Systems and Computer Engineering, Technology and Science, 4200-465 Porto, Portugal"},{"name":"School of Sciences and Technology, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7013-9700","authenticated-orcid":false,"given":"Jo\u00e3o Dallyson","family":"Almeida","sequence":"additional","affiliation":[{"name":"Applied Computing Group, UFMA\u2014Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds 65080-805, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3458-7693","authenticated-orcid":false,"given":"Ant\u00f3nio Trigueiros","family":"Cunha","sequence":"additional","affiliation":[{"name":"School of Sciences and Technology, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"},{"name":"ALGORITMI Research Centre, University of Minho, 4800-058 Guimar\u00e3es, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"372","DOI":"10.18203\/2349-2902.isj20230486","article-title":"The relationship between colorectal polyps and colon cancer with Helicobacter pylori infection","volume":"10","author":"Aghayeva","year":"2023","journal-title":"Int. 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