JDCNet Uses Confidence Gated Privileged Modality Distillation for Cost Preserving X Ray Inference
Training-only privileged-modality learning uses an expensive modality during training while keeping a single-modality deployment path. We study chest radiograph (X-ray) classification with same-patient computed tomography (CT) available only during training. JDCNet adds an auxiliary CT-teacher target, the teacher's argmax label or its softmax distribution through a Kullback--Leibler term (soft-KL), only on samples whose teacher confidence exceeds a threshold; the deployed model has the same ResNet-18 computation graph as the supervised baseline. On 510 same-patient pairs from the public BIMCV-COVID19 releases of the Valencian Region Medical ImageBank (113 COVID-19, 397 non-COVID), with patient-level five-fold cross-validation and three seeds, 15 of 16 adaptively explored JDCNet configurations improved mean balanced accuracy (BA) over the supervised baseline (average $+0.020$), but none remained significant after Holm adjustment. In a pre-registered experiment with 240 batch-matched supervised restarts on the same splits, batch size had no detectable effect on the baseline (BA $0.620$ versus $0.625$), and when both methods selected one of 16 runs per cell on the validation partition, JDCNet exceeded supervised training by $+0.037$ BA (95\% confidence interval $+0.016$ to $+0.058$; patient-level $+0.007$ to $+0.068$). Logit distillation and contrastive alignment did not help. Teacher diagnostics indicate that the gate acts mainly as CT-informed sample weighting. All models, including JDCNet, performed at chance on an external radiograph set. Confidence-gated CT supervision thus gives a small within-cohort advantage on one public cohort and a binary task; generalization requires independent paired replication.