LDCT Denoising

The Natural Image Quality Evaluator (NIQE) scores an image by its statistical distance from a model fitted on pristine images, and its distributed model is fitted on photographs. We release the Radiology Image Quality Evaluator (RIQE), a NIQE-style model fitted on 3,792 full-dose slices from 158 patients of the public LDCT-and-Projection-data collection, with a declared intensity mapping, a manifest of every slice and a script that reproduces the fit. On 40 held-out patients, RIQE ranks reduced-dose reconstructions, simulated by projection-domain noise insertion, worse than the full-dose reconstruction of the same slice in 240 of 240 chest and 230 of 240 abdominal pairs, and ranks images with 20% more noise worse than their source in 97.5-100% of cases. Its preferences among filtered images, however, do not follow lesion signal. With a 4 mm, +10 HU lesion inserted in noisy abdominal slices, RIQE prefers bilateral filtering to the unfiltered image in every image up to a 32 HU residual, at which 29% of the lesion's matched-filter signal remains and its detectability index falls from 0.51 to 0.33; it never prefers Gaussian smoothing, which at the same 32 HU residual leaves 70% of the signal and a detectability index of 0.48. Fitted on photographs with the parameters published for NIQE, the same code ranks every simulated reduced-dose abdominal image better than its full-dose counterpart. RIQE is suited to ranking a degraded image against its source; under the conditions tested it should not be the sole criterion for selecting, comparing or tuning denoisers.

Low-dose computed tomography (LDCT) measurements contain mixed Poisson-Gaussian noise. However, most self-supervised methods rely on generic image statistics and do not explicitly model this noise, which may limit their ability to effectively suppress realistic LDCT noise. To address this issue, we propose a physics-driven framework with cross-domain iteration for self-supervised LDCT denoising. The proposed framework proceeds in three main steps. First, a learned sinogram prior and the LDCT noise model guide posterior inference of photon counts, enabling separation of the Poisson and Gaussian components. Second, the separated Poisson and Gaussian components are respectively processed by binomial thinning and Gaussian data thinning to construct two branches, and residual scaling matches each branch's noise level to that of the observation, yielding a training pair with approximately independent noise realizations from one low-dose measurement. Finally, the pair is used to train an image-domain network whose forward-projected outputs update the prior. Through cross-domain iteration, the prior and the training pair are progressively refined while maintaining consistency with CT acquisition physics. Experiments on simulated data from AAPM, LIDC-IDRI, and LoDoPaB-CT and on real LDCT data show consistent gains over the evaluated self-supervised baselines across dose levels, with performance comparable to the evaluated supervised baseline.

While deep learning-based denoising has become widely adopted in low-dose CT, conventional models use generic architectures designed for natural images, failing to account for non-stationary and spatially correlated CT noise characteristics. To address this, we propose an Efficient Noise COntext-aware REpresentation (ENCORE) framework that explicitly leverages CT noise characteristics and anatomical features. First, we reformulate the noise synthesis procedure based on a realistic noise distribution beyond the conventional Gaussian approximation, establishing a rigorous foundation for training pair generation. Next, we extract local noise power and correlation contexts to guide the denoising process. To fully leverage the potential of noise context, we propose a FlyingConv module, which adaptively changes convolution weights for each local image region. Notably, our approach demonstrates substantial gains in both denoising quality and computational efficiency. Furthermore, manipulating the intensity of the noise context maps at inference time enables zero-shot conditional denoising, allowing for dynamic control over the output image texture. The entire pipeline is available at https://github.com/minwoo-yu/ENCORE.git

Computed tomography (CT) is a critical imaging modality for clinical diagnosis, but reducing radiation dose inevitably introduces severe noise and structured artifacts that degrade image quality. Existing deep learning-based low-dose CT (LDCT) reconstruction methods are typically optimized for fixed dose levels or specific anatomical regions, limiting their robustness and generalization in realistic clinical settings. We propose GenDiff, a generalizable diffusion-based framework for LDCT reconstruction that jointly models continuous radiation dose and anatomical information within a unified reconstruction network. The proposed framework integrates a Dose-Anatomy Encoder to learn acquisition-aware embeddings, a dose- and anatomy-conditioned cold diffusion backbone for iterative refinement, a physics-consistency update to enforce fidelity to the CT forward model, and a Structural Prior Refinement Module (SPRM) that preserves anatomical structures while suppressing dose-dependent artifacts. Extensive experiments on multi-anatomy clinical datasets, including unseen ultra-low-dose conditions as well as out-of-distribution phantom and animal datasets, demonstrate that GenDiff consistently outperforms state-of-the-art convolutional neural network and diffusion-based reconstruction methods. The proposed approach achieves superior reconstruction quality while maintaining strong robustness across different dose levels, anatomical regions, and acquisition domains, making it a promising solution for practical low-dose CT imaging.

Low-dose computed tomography (LDCT) reduces radiation exposure but introduces stronger quantum noise, streak artifacts, and local texture degradation, which can obscure anatomical boundaries and weaken low-contrast structures. Diffusion models are promising for LDCT denoising by progressively recovering normal-dose CT (NDCT) images from degraded LDCT inputs, but existing methods often suffer from insufficient anatomical guidance, uncertain frequency-dependent recovery, and uniform reverse-process modeling. We propose ProSAC-CT, a progressive spectral-anatomical co-guided multi-stage diffusion model for image-domain LDCT denoising. ProSAC-CT integrates an anatomical-prior-guided conditioning (APGC) module, a residual frequency-domain decoupling stage (RFDDS), and a time-step-decoupling denoising decoder (TD3). APGC extracts LDCT-derived structural guidance, RFDDS enhances frequency-aware representations, and TD3 assigns them to different reverse-diffusion stages for anatomical stabilization, boundary refinement, and fine-detail recovery. Experiments on four LDCT degradation benchmarks show that ProSAC-CT improves image fidelity, structural similarity, perceptual quality, and information preservation over representative methods while better preserving boundary-sensitive anatomical details. Downstream anatomical-region classification on Mayo-2020 further indicates that ProSAC-CT retains task-relevant anatomical information, supporting its practical use for low-dose CT denoising.

Computed tomography (CT) plays a crucial role in medical diagnosis, but minimizing radiation exposure while maintaining image quality remains a critical challenge. Low-dose CT (LDCT) protocols reduce radiation risks but inevitably suffer from severe noise and artifacts that compromise diagnostic accuracy. While existing deep learning methods have achieved promising results, there remains a continuous quest for generative paradigms that intrinsically capture global-to-local structural dependencies to better preserve fine anatomical details. To this end, we propose DeVAR, a novel generative framework that applies visual autoregressive modeling (VAR) to LDCT denoising for the first time. Conditioned on global context provided by LDCT prefix tokens, DeVAR progressively generates discrete token maps of the target normal-dose CT (NDCT) via next-scale prediction. Because quantization inherently discards high-frequency information, we introduce a residual refiner to capture subtle anatomical structures beyond the capacity of a discrete codebook. Finally, empowered by a dual-representation hybrid training strategy, our hybrid NDCT decoder seamlessly integrates continuous and discrete latents to reconstruct high-fidelity, detail-preserved images. Extensive experiments on two public datasets demonstrate that DeVAR consistently achieves superior qualitative and quantitative performance compared to state-of-the-art LDCT denoising methods.

Despite extensive research on computed tomography (CT) denoising, few studies exploit projection-domain data characteristics to mitigate noise correlation. To bridge this gap, this work proposes FrequencyCT, the first zero-shot self-supervised method for pseudo-sample generation in the frequency domain for low-dose CT denoising. Specifically, by exploiting the distinct frequency-domain distributions of noise and true signal, a regional low-frequency anchoring technique is proposed. Applying phase-preserving noise and mask perturbations to the high-frequency region generates pseudo-samples for self-supervision. Driven by the exponential correlation between noise variance of noisy projections and the underlying true signal, consistent data truncation is applied to the generated samples to stabilize optimization gradients. Evaluation results on multiple public and real datasets confirm the clinical application potential of this research, which provides an innovative perspective for the field of denoising. The code is available at: https://github.com/yqx7150/FrequencyCT.

Propagation-based X-ray phase-contrast imaging (PBI) enables high-contrast visualization of lung structures and holds strong medical potential. However, safe translation to the clinic will require a substantial radiation dose reduction, which inevitably increases image noise. Supervised convolutional-neural-network-based denoising can restore image quality but depends on paired low- and high-dose datasets, which are rarely available in practice. Self-supervised methods avoid this limitation, yet most are not well adapted to the inverse problem of PBI computed tomography (CT). We introduce Neighbor2Inverse, a self-supervised denoising framework designed for low-dose PBI-CT that generalizes to clinical CT. Building on the Neighbor2Neighbor principle, each noisy projection is subsampled into two variants that preserve structural information but contain independent noise realizations. These are reconstructed separately, and the resulting pairs are used to train a denoising network directly in the image domain. We benchmark the proposed method against established analytical and self-supervised denoising approaches. In region-of-interest PBI CT experiments, Neighbor2Inverse achieves superior noise suppression while preserving fine structural details, as demonstrated by improved contrast-to-noise ratio, spatial resolution, and composite image quality metrics. Competitive performance is also observed on clinical CT data under simulated low-dose conditions. This work has been submitted to the IEEE for possible publication. Copyright may be transferred without notice, after which this version may no longer be accessible. Code, data, and interactive figures are available at https://github.com/J-3TO/Neighbor2Inverse.

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 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.