Implicit representations are dead. Long live explicit primitives!
Continuous parameterization of medical data has emerged as a powerful paradigm for resolution-independent image representation. While Implicit Neural Representations offer high fidelity and compact storage, their reliance on global Multi-Layer Perceptrons incurs sizeable computational costs, large memory requirements, and extensive optimization times. As medical imaging trends towards ever-more detailed, high-resolution volumes, these costs impose significant bottlenecks in the applicability of implicit approaches. Recently, explicit Gaussian-based primitives have revolutionized the representation learning paradigm by trading deep network evaluations for localized, rasterization-friendly primitives. In this paper, we present a comprehensive, cross-dimensional evaluation of Gaussian representations against implicit approaches for medical imaging applications. First, we outline a theoretical overview on the mathematical properties offered by explicit primitives beyond what is capable under the implicit neural paradigm. Subsequently, we benchmark the computational performance on two demanding image datasets: 2D microscopy histology and 3D lung Computed Tomography (CT). Our experiments demonstrate that Gaussian representations consistently match or surpass reconstruction metrics compared to implicit methods across all compression factors, while displaying significantly lower optimization times, and memory requirements. Together with the compelling mathematical properties offered by explicit primitives, these findings motivate the wider adoption of Gaussian representations and position them as an attractive direction for future research in medical imaging.