ProtoCLIP: Prototype-Aligned Latent Refinement for Robust Zero-Shot Chest X-Ray Classification

• URL: http://arxiv.org/abs/2604.18444v1
• Date: Mon, 20 Apr 2026 16:01:44 GMT
• Title: ProtoCLIP: Prototype-Aligned Latent Refinement for Robust Zero-Shot Chest X-Ray Classification
• Abstract summary: We propose ProtoCLIP, a refinement strategy for CLIP-style vision-language models (VLMs)<n>We construct pathology-focused training subsets with curated negative samples to reduce co-occurrence bias.<n>We also introduce a representation-preserving distillation objective to stabilize adaptation while maintaining semantic structure.
• Score: 3.428885759047836
• License: http://arxiv.org/licenses/nonexclusive-distrib/1.0/
• Abstract: Zero-shot vision-language models (VLMs) have shown promise for chest radiograph classification, but their performance is often limited by confounding label co-occurrence, long-tail class imbalance, and transfer instability under domain shift. We propose ProtoCLIP, a refinement strategy for CLIP-style VLMs that improves zero-shot discrimination through targeted data curation and distilled anchor alignment. Specifically, we construct pathology-focused training subsets with curated negative samples to reduce co-occurrence bias. We also introduce a representation-preserving distillation objective to stabilize adaptation while maintaining semantic structure and improving discrimination of clinically relevant co-occurring pathologies. Evaluated on an unseen dataset VinDr-CXR, ProtoCLIP improves AUC by 2-10 percentage points over a strong CLIP-based baseline across multiple findings. For pneumothorax specifically, ProtoCLIP achieves a state-of-the-art AUC of 0.94. These results demonstrate that anchor-guided refinement, coupled with curated supervision and controlled adaptation, can mitigate common zero-shot transfer failures in medical VLMs without requiring large-scale retraining.

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