This review investigates the application of Explainable Artificial Intelligence (XAI) in biomedical informatics, encompassing domains such as medical imaging, genomics, and electronic health records. Through a systematic analysis of 43 peer-reviewed articles, we examine current trends, as well as the strengths and limitations of methodologies currently used in real-world healthcare settings. Our findings highlight a growing interest in XAI, particularly in medical imaging, yet reveal persistent challenges in clinical adoption, including issues of trust, interpretability, and integration into decision-making workflows. We identify critical gaps in existing approaches and underscore the need for more robust, human-centred, and intrinsically interpretable models, with only 44% of the papers studied proposing human-centred validations. Furthermore, we argue that fairness and accountability, which are key to the acceptance of AI in clinical practice, can be supported by the use of post hoc tools for identifying potential biases but ultimately require the implementation of complementary fairness-aware or causal approaches alongside evaluation frameworks that prioritise clinical relevance and user trust. This review provides a foundation for advancing XAI research on the development of more transparent, equitable, and clinically meaningful AI systems for use in healthcare.

Fluorescence microscopy is widely employed for the analysis of living biological samples; however, the utility of the resulting recordings is frequently constrained by noise, temporal variability, and inconsistent visualisation of signals that oscillate over time. We present a unique computational framework that integrates information from multiple time-resolved frames into a single high-quality image, while preserving the underlying biological content of the original video. We evaluate the proposed method through an extensive number of configurations (n = 111) and on a challenging dataset comprising dynamic, heterogeneous, and morphologically complex 2D monolayers of cardiac cells. Results show that our framework, which consists of a combination of explainable techniques from different computer vision application fields, is capable of generating composite images that preserve and enhance the quality and information of individual microscopy frames, yielding 44% average increase in cell count compared to previous methods. The proposed pipeline is applicable to other imaging domains that require the fusion of multi-temporal image stacks into high-quality 2D images, thereby facilitating annotation and downstream segmentation.