Abstract
Unlike high-dose scans, low-dose cardiac CT perfusion imaging reduces patient radiation exposure and thereby the risk of potential health effects. However, it introduces significant image noise, degrading diagnostic quality and limiting clinical assessment. Denoising is thus a critical preprocessing step to enhance image quality without compromising anatomical or perfusion details. Traditionally used reconstruction-domain methods, such as Iterative Reconstruction and Compressed Sensing, are often limited by algorithmic complexity, dependence on raw sinogram data, and restricted adaptability. Conversely, image-domain methods offer more adaptable denoising options. Recently, learning-based approaches have further expanded this flexibility and demonstrated state-of-the-art performance across various denoising tasks. In this work, we present a deep learning-based denoising method specifically tuned for low-dose cardiac CT perfusion imaging. Our model is trained to reduce noise while preserving structural integrity and temporal contrast dynamics, which are critical for downstream analysis. Unlike many existing methods, our approach is optimized for perfusion data, where temporal consistency is essential. Residual cardiac motion remains a separate challenge, which we aim to address in our future work. Experimental results show significant improvements in quantitative image quality, using both reference-based and no-reference metrics, such as MSE/PSNR/SSIM and NIQE/FID/KID, as well as improved accuracy of perfusion measurements.