Coarse-to-Fine Diffusion with Residual Prior for Low-Dose CT Denoising
Low-dose CT (LDCT) reduces radiation exposure but often introduces severe noise and streak artifacts that obscure subtle anatomical structures. Existing diffusion-based denoising methods commonly rely on implicit assumptions about the noise distribution, which may not hold in practical LDCT scenarios and can degrade denoising performance. To address this limitation, we propose a Residual-Guided Diffusion framework that effectively incorporates an explicit difference prior to inform the diffusion process of noise distribution. The difference prior is computed as the residual between the LDCT image and a coarse clean estimate, constraining diffusion sampling to a plausible residual space. We further adopt a coarse-to-fine strategy in which a pre-trained RED-CNN provides the coarse estimate to anchor global anatomy, and the diffusion model refines the remaining details under the prior guidance. For efficiency, we employ accelerated sampling with 20 steps at inference. Experiments on three representative datasets demonstrate that our approach outperforms existing methods in both quantitative and qualitative performance measures.