SCCL-DT: Semantic-Conflict-Aware Contrastive Learning with Dual-Rule Teacher Distillation for Zero-Shot Chest X-Ray Diagnosis

Contrastive vision-language pre-training supports zero-shot chest X-ray diagnosis, but standard objectives treat every off-diagonal image-report pair in a batch as a negative. In radiology, recurring findings across patients mean that instance mismatch need not imply semantic incompatibility, creati