A deep dictionary network-based foundation model for ultra-low-dose CT denoising

Low-dose computed tomography (CT) denoising is crucial for reduced radiation exposure while ensuring diagnostically acceptable image quality. Despite significant advancements driven by deep learning (DL) in recent years, existing DL-based methods, typically trained on a specific dose level and anatomical region, struggle to handle diverse noise characteristics and anatomical heterogeneity during varied scanning conditions, limiting their generalizability and robustness in clinical scenarios. In this paper, we propose FoundDiff, a foundational diffusion model for unified and generalizable LDCT denoising across various dose levels and anatomical regions. FoundDiff employs a two-stage strategy: (i) dose-anatomy perception and (ii) adaptive denoising. First, we develop a dose- and anatomy-aware contrastive language-image pre-training model (DA-CLIP) to achieve robust dose and anatomy perception by leveraging specialized contrastive learning strategies to learn continuous representations that quantify ordinal dose variations and identify salient anatomical regions. Second, we design a dose- and anatomy-aware diffusion model (DA-Diff) to perform adaptive and generalizable denoising by synergistically integrating the learned dose and anatomy embeddings from DA-CLIP into diffusion process via a novel dose and anatomy conditional block (DACB) based on Mamba. Extensive experiments on a large simulated multi-dose CT dataset spanning three anatomical regions, together with cross-dataset evaluations on Mayo-2016, CQ500, and piglet datasets, demonstrate superior denoising performance and strong generalization to unseen dose levels and anatomical regions. The codes and models are available at https: //github.com/hao1635/FoundDiff.

With the development of deep learning, medical image processing has been widely used to assist clinical research. This paper focuses on the denoising problem of low-dose computed tomography using deep learning. Although low-dose computed tomography reduces radiation exposure to patients, it also introduces more noise, which may interfere with visual interpretation by physicians and affect diagnostic results. To address this problem, inspired by Cycle-GAN for unsupervised learning, this paper proposes an end-to-end unsupervised low-dose computed tomography denoising framework. The proposed framework combines a U-Net structure for multi-scale feature extraction, an attention mechanism for feature fusion, and a residual network for feature transformation. It also introduces perceptual loss to improve the network for the characteristics of medical images. In addition, we construct a real low-dose computed tomography dataset and design a large number of comparative experiments to validate the proposed method, using both image-based evaluation metrics and medical evaluation criteria. Compared with classical methods, the main advantage of this paper is that it addresses the limitation that real clinical data cannot be directly used for supervised learning, while still achieving excellent performance. The experimental results are also professionally evaluated by imaging physicians and meet clinical needs.

Low-dose CT images are essential for reducing radiation exposure in cancer screening, pediatric imaging, and longitudinal monitoring protocols, but their quality is often degraded by noise from low-dose acquisition, patient motion, or scanner limitations, affecting both clinical interpretation and downstream analysis. Traditional filtering approaches often over-smooth and lose fine anatomical details, while deep learning methods, including CNNs, GANs, and transformers, may struggle to preserve such details or require large, computationally expensive models, limiting clinical practicality. We propose PatchDenoiser, a lightweight, energy-efficient multi-scale patch-based denoising framework. It decomposes denoising into local texture extraction and global context aggregation, fused via a spatially aware patch fusion strategy. This design enables effective noise suppression while preserving fine structural and anatomical details. PatchDenoiser is ultra-lightweight, with far fewer parameters and lower computational complexity than CNN, GAN, and transformer based denoisers. On the 2016 Mayo Low-Dose CT dataset, PatchDenoiser consistently outperforms state-of-the-art CNN- and GAN-based methods in PSNR and SSIM. It is robust to variations in slice thickness, reconstruction kernels, and HU windows, generalizes across scanners without fine-tuning, and reduces parameters by ~9x and energy consumption per inference by ~27x compared with conventional CNN denoisers. PatchDenoiser thus provides a practical, scalable, and computationally efficient solution for medical image denoising, balancing performance, robustness, and clinical deployability.