An image processing device or system, in particular for medical image processing, comprises an interface to receive image data, a storage system, and at least one integrated circuit operative to retrieve an image analysis model from the storage system, perform an image analysis that comprises applying the image analysis model to the image data to generate an image analysis output, generate an explainability signature for the image analysis, process at least the explainability signature to generate cross-check data indicative of a class prediction and/or a possible discrepancy in the image analysis, and initiate a control action that depends on the cross-check data.