Do Quantum Kernels Improve Medical Image Classification? A Leakage-Controlled Benchmark Against Classical RBF-SVM

Abstract Quantum kernel methods are often proposed as a route to improved medical image classification because quantum feature maps can embed data into high-dimensional Hilbert spaces. However, their practical value remains unclear when compared with strong classical kernels under leakage-controlled conditions. This study benchmarks two simulated quantum kernel support vector machines, QSVM-ZZ and QSVM-Pauli, against logistic regression, linear SVM, fixed-default RBF-SVM, and a compact multi-layer perceptron on BrainTumorMRI and BreastMNIST. All models used identical frozen ResNet18 features, train-only standardisation, PCA compression to four and eight dimensions, three random seeds, and matched classifier-training budgets where applicable. Across 24 seed-level matched comparisons, the best quantum kernel model never outperformed the best classical model. The mean quantum-minus-classical macro-F1 gap was − 0.2230, with all 24 gaps negative. Fixed pairwise comparisons confirmed that RBF-SVM exceeded both quantum kernels individually. QSVMs also required approximately 50 × to more than 220 × higher runtime. These findings show that, for compressed ResNet18 medical image features under noiseless simulation, the tested QSVM-ZZ and QSVM-Pauli kernels did not provide a practical advantage over fixed-default RBF-SVM.