Medical image acquisition is often intervented by unwanted noise that corrupts the information content. This paper introduces an unsupervised medical image denoising technique that learns noise characteristics from the available images and constructs denoised images. It comprises of two blocks of data processing, viz., patch-based dictionaries that indirectly learn the noise and residual learning (RL) that directly learns the noise. The model is generalized to account for both 2D and 3D images considering different medical imaging instruments. The images are considered one-by-one from the stack of MRI/CT images as well as the entire stack is considered, and decomposed into overlapping image/volume patches. These patches are given to the patch-based dictionary learning to learn noise characteristics via sparse representation while given to the RL part to directly learn the noise properties. K-singular value decomposition (K-SVD) algorithm for sparse representation is used for training patch-based dictionaries. On the other hand, residue in the patches is trained using the proposed deep residue network. Iterating on these two parts, an optimum noise characterization for each image/volume patch is captured and in turn it is subtracted from the available respective image/volume patch. The obtained denoised image/volume patches are finally assembled to a denoised image or 3D stack. We provide an analysis of the proposed approach with other approaches. Experiments on MRI/CT datasets are run on a GPU-based supercomputer and the comparative results show that the proposed algorithm preserves the critical information in the images as well as improves the visual quality of the images.
Recently, much progress has been made in unsupervised denoising learning. However, existing methods more or less rely on some assumptions on the signal and/or degradation model, which limits their practical performance. How to construct an optimal criterion for unsupervised denoising learning without any prior knowledge on the degradation model is still an open question. Toward answering this question, this work proposes a criterion for unsupervised denoising learning based on the optimal transport theory. This criterion has favorable properties, e.g., approximately maximal preservation of the…
We cast the problem of image denoising as a domain translation problem between high and low noise domains. By modifying the cycleGAN model, we are able to learn a mapping between these domains on unpaired retinal optical coherence tomography images. In quantitative measurements and a qualitative evaluation by ophthalmologists, we show how this approach outperforms other established methods. The results indicate that the network differentiates subtle changes in the level of noise in the image. Further investigation of the model's feature maps reveals that it has learned to distinguish retinal l…
Center for Systems Biology Dresden(德累斯顿系统生物学中心);Max-Planck Institute (CBG)(马克斯·普朗克分子细胞生物学与遗传学研究所);School of Computer Science(计算机科学学院);University of Birmingham(伯明翰大学);Fondazione Human Technopole(人类技术基金会)
Deep Learning based methods have emerged as the indisputable leaders for virtually all image restoration tasks. Especially in the domain of microscopy images, various content-aware image restoration (CARE) approaches are now used to improve the interpretability of acquired data. Naturally, there are limitations to what can be restored in corrupted images, and like for all inverse problems, many potential solutions exist, and one of them must be chosen. Here, we propose DivNoising, a denoising approach based on fully convolutional variational autoencoders (VAEs), overcoming the problem of havin…
National Tsing Hua University(国立清华大学);Florida International University(佛罗里达国际大学);Lehigh University(理海大学);Guangdong Provincial People’s Hospital(广东省人民医院);Guangdong Academy of Medical Science(广东省医学科学院);University of Notre Dame(圣母大学)
Deep learning had already demonstrated its power in medical images, including denoising, classification, segmentation, etc. All these applications are proposed to automatically analyze medical images beforehand, which brings more information to radiologists during clinical assessment for accuracy improvement. Recently, many medical denoising methods had shown their significant artifact reduction result and noise removal both quantitatively and qualitatively. However, those existing methods are developed around human-vision, i.e., they are designed to minimize the noise effect that can be perce…
Nosie is an important cause of low quality Optical coherence tomography (OCT) image. The neural network model based on Convolutional neural networks(CNNs) has demonstrated its excellent performance in image denoising. However, OCT image denoising still faces great challenges because many previous neural network algorithms required a large number of labeled data, which might cost much time or is expensive. Besides, these CNN-based algorithms need numerous parameters and good tuning techniques, which is hardware resources consuming. To solved above problems, We proposed a new Cycle-Consistent Ge…
Interpretation of medical images for diagnosis and treatment of complex disease from high-dimensional and heterogeneous data remains a key challenge in transforming healthcare. In the last few years, both supervised and unsupervised deep learning achieved promising results in the area of medical imaging and image analysis. Unlike supervised learning which is biased towards how it is being supervised and manual efforts to create class label for the algorithm, unsupervised learning derive insights directly from the data itself, group the data and help to make data driven decisions without any ex…
Peking University(北京大学);Academy for Advanced Interdisciplinary Studies(前沿交叉学科研究院);Massachusetts General Hospital(麻省总医院);Harvard Medical School(哈佛医学院)
We propose a novel and unified method, measurement-conditioned denoising diffusion probabilistic model (MC-DDPM), for under-sampled medical image reconstruction based on DDPM. Different from previous works, MC-DDPM is defined in measurement domain (e.g. k-space in MRI reconstruction) and conditioned on under-sampling mask. We apply this method to accelerate MRI reconstruction and the experimental results show excellent performance, outperforming full supervision baseline and the state-of-the-art score-based reconstruction method. Due to its generative nature, MC-DDPM can also quantify the unce…
University of Copenhagen(哥本哈根大学);Rigshospitalet(哥本哈根大学国立医院)
Generative models such as Generative Adversarial Networks (GANs) and Variational Autoencoders (VAEs) play an increasingly important role in medical image analysis. The latent spaces of these models often show semantically meaningful directions corresponding to human-interpretable image transformations. However, until now, their exploration for medical images has been limited due to the requirement of supervised data. Several methods for unsupervised discovery of interpretable directions in GAN latent spaces have shown interesting results on natural images. This work explores the potential of a…
University Hospital Aachen(亚琛大学医院);RWTH Aachen University(亚琛工业大学);Ocumeda AG(奥库梅达股份公司);University Hospital Heidelberg(海德堡大学医院);University Hospital Würzburg(维尔茨堡大学医院);University of Mainz(美因茨大学);RWTH Aachen(亚琛工业大学)
Recent advances in computer vision have shown promising results in image generation. Diffusion probabilistic models in particular have generated realistic images from textual input, as demonstrated by DALL-E 2, Imagen and Stable Diffusion. However, their use in medicine, where image data typically comprises three-dimensional volumes, has not been systematically evaluated. Synthetic images may play a crucial role in privacy preserving artificial intelligence and can also be used to augment small datasets. Here we show that diffusion probabilistic models can synthesize high quality medical imagi…
Image denoising is an important pre-processing step in medical image analysis. Different algorithms have been proposed in past three decades with varying denoising performances. More recently, having outperformed all conventional methods, deep learning based models have shown a great promise. These methods are however limited for requirement of large training sample size and high computational costs. In this paper we show that using small sample size, denoising autoencoders constructed using convolutional layers can be used for efficient denoising of medical images. Heterogeneous images can be…
University of Oulu(奥卢大学);University College London(伦敦大学学院)
Multi-energy computed tomography (CT) with photon counting detectors (PCDs) enables spectral imaging as PCDs can assign the incoming photons to specific energy channels. However, PCDs with many spectral channels drastically increase the computational complexity of the CT reconstruction, and bespoke reconstruction algorithms need fine-tuning to varying noise statistics. \rev{Especially if many projections are taken, a large amount of data has to be collected and stored. Sparse view CT is one solution for data reduction. However, these issues are especially exacerbated when sparse imaging scenar…
Center for Advanced Medical Computing and Analysis, Massachusetts General Hospital and Harvard Medical School(麻省总医院与哈佛医学院高级医学计算与分析中心);Gordon Center for Medical Imaging, Massachusetts General Hospital and Harvard Medical School(麻省总医院与哈佛医学院戈登医学成像中心)
Deep neural networks have been proved efficient for medical image denoising. Current training methods require both noisy and clean images. However, clean images cannot be acquired for many practical medical applications due to naturally noisy signal, such as dynamic imaging, spectral computed tomography, arterial spin labeling magnetic resonance imaging, etc. In this paper we proposed a training method which learned denoising neural networks from noisy training samples only. Training data in the acquisition domain was split to two subsets and the network was trained to map one noisy set to the…
University of Electronic Science and Technology of China(电子科技大学);Sichuan University(四川大学)
Deep learning has achieved notable performance in the denoising task of low-quality medical images and the detection task of lesions, respectively. However, existing low-quality medical image denoising approaches are disconnected from the detection task of lesions. Intuitively, the quality of denoised images will influence the lesion detection accuracy that in turn can be used to affect the denoising performance. To this end, we propose a play-and-plug medical image denoising framework, namely Lesion-Inspired Denoising Network (LIDnet), to collaboratively improve both denoising performance and…
Image denoising is of great importance for medical imaging system, since it can improve image quality for disease diagnosis and downstream image analyses. In a variety of applications, dynamic imaging techniques are utilized to capture the time-varying features of the subject, where multiple images are acquired for the same subject at different time points. Although signal-to-noise ratio of each time frame is usually limited by the short acquisition time, the correlation among different time frames can be exploited to improve denoising results with shared information across time frames. With t…
Information Technology University(信息技术大学);University of Toronto(多伦多大学)
Among the plethora of techniques devised to curb the prevalence of noise in medical images, deep learning based approaches have shown the most promise. However, one critical limitation of these deep learning based denoisers is the requirement of high-quality noiseless ground truth images that are difficult to obtain in many medical imaging applications such as X-rays. To circumvent this issue, we leverage recently proposed approach of [7] that incorporates Stein's Unbiased Risk Estimator (SURE) to train a deep convolutional neural network without requiring denoised ground truth X-ray data. Our…
City, University of London(伦敦大学城市学院);Imperial College(帝国理工学院)
We propose a novel unsupervised out-of-distribution detection method for medical images based on implicit fields image representations. In our approach, an auto-decoder feed-forward neural network learns the distribution of healthy images in the form of a mapping between spatial coordinates and probabilities over a proxy for tissue types. At inference time, the learnt distribution is used to retrieve, from a given test image, a restoration, i.e. an image maximally consistent with the input one but belonging to the healthy distribution. Anomalies are localized using the voxel-wise probability p…
Johns Hopkins Medical Institutes(约翰斯·霍普金斯医学院);Johns Hopkins University(约翰斯·霍普金斯大学);Department of Radiology and Radiological Science(放射学与放射科学系);Department of Electrical and Computer Engineering(电气与计算机工程系)
For the majority of the learning-based segmentation methods, a large quantity of high-quality training data is required. In this paper, we present a novel learning-based segmentation model that could be trained semi- or un- supervised. Specifically, in the unsupervised setting, we parameterize the Active contour without edges (ACWE) framework via a convolutional neural network (ConvNet), and optimize the parameters of the ConvNet using a self-supervised method. In another setting (semi-supervised), the auxiliary segmentation ground truth is used during training. We show that the method provide…
Towards Universal Unsupervised Anomaly Detection in Medical Imaging
Technical University of Munich(慕尼黑工业大学);Helmholtz AI and Helmholtz Center Munich(亥姆霍兹人工智能与亥姆霍兹慕尼黑中心);Klinikum Rechts der Isar(伊萨尔河右岸医院);Imperial College London(伦敦帝国理工学院)
Optical coherence tomography (OCT) is a prevalent non-invasive imaging method which provides high resolution volumetric visualization of retina. However, its inherent defect, the speckle noise, can seriously deteriorate the tissue visibility in OCT. Deep learning based approaches have been widely used for image restoration, but most of these require a noise-free reference image for supervision. In this study, we present a diffusion probabilistic model that is fully unsupervised to learn from noise instead of signal. A diffusion process is defined by adding a sequence of Gaussian noise to self-…
University of Rome Tor Vergata(罗马第二大学);University of Cambridge(剑桥大学);Athinoula A. Martinos Center for Biomedical Imaging(阿西诺拉·A·马蒂诺斯生物医学成像中心)
The lack of large labeled medical imaging datasets, along with significant inter-individual variability compared to clinically established disease classes, poses significant challenges in exploiting medical imaging information in a precision medicine paradigm, where in principle dense patient-specific data can be employed to formulate individual predictions and/or stratify patients into finer-grained groups which may follow more homogeneous trajectories and therefore empower clinical trials. In order to efficiently explore the effective degrees of freedom underlying variability in medical imag…
South China University of Technology(华南理工大学);Pazhou Lab(琶洲实验室);Tencent AI Lab(腾讯人工智能实验室)
Deep learning based medical image diagnosis has shown great potential in clinical medicine. However, it often suffers two major difficulties in real-world applications: 1) only limited labels are available for model training, due to expensive annotation costs over medical images; 2) labeled images may contain considerable label noise (e.g., mislabeling labels) due to diagnostic difficulties of diseases. To address these, we seek to exploit rich labeled data from relevant domains to help the learning in the target task via {Unsupervised Domain Adaptation} (UDA). Unlike most UDA methods that rel…
Computational Imaging Research Lab (CIR)(计算成像研究实验室(CIR));Department of Biomedical Imaging and Image-guided Therapy(生物医学成像与影像引导治疗系);Medical University of Vienna(维也纳医科大学)
Predictive marker patterns in imaging data are a means to quantify disease and progression, but their identification is challenging, if the underlying biology is poorly understood. Here, we present a method to identify predictive texture patterns in medical images in an unsupervised way. Based on deep clustering networks, we simultaneously encode and cluster medical image patches in a low-dimensional latent space. The resulting clusters serve as features for disease staging, linking them to the underlying disease. We evaluate the method on 70 T1-weighted magnetic resonance images of patients w…
RelativeFlow: Taming Medical Image Denoising Learning with Noisy Reference
School of Computer Science and Engineering, Southeast University, China(东南大学计算机科学与工程学院,中国);Department of Biomedical Engineering, Case Western Reserve University, USA(凯斯西储大学生物医学工程系,美国);School of Instrument Science and Engineering, Southeast University, China(东南大学仪器科学与工程学院,中国);Department of Optical Sciences, University of Arizona, USA(亚利桑那大学光学科学系,美国)
Universidad San Francisco de Quito(旧金山基多大学);University of South Florida(南佛罗里达大学)
Deep learning models have obtained state-of-the-art results for medical image analysis. However, when these models are tested on an unseen domain there is a significant performance degradation. In this work, we present an unsupervised Cross-Modality Adversarial Domain Adaptation (C-MADA) framework for medical image segmentation. C-MADA implements an image- and feature-level adaptation method in a sequential manner. First, images from the source domain are translated to the target domain through an un-paired image-to-image adversarial translation with cycle-consistency loss. Then, a U-Net netwo…
University of Stuttgart(斯图加特大学);University of Tübingen(蒂宾根大学);King’s College London(伦敦国王学院)
Image-to-image translation is a new field in computer vision with multiple potential applications in the medical domain. However, for supervised image translation frameworks, co-registered datasets, paired in a pixel-wise sense, are required. This is often difficult to acquire in realistic medical scenarios. On the other hand, unsupervised translation frameworks often result in blurred translated images with unrealistic details. In this work, we propose a new unsupervised translation framework which is titled Cycle-MedGAN. The proposed framework utilizes new non-adversarial cycle losses which …
Australian Institute for Machine Learning, The University of Adelaide(阿德莱德大学澳大利亚机器学习研究所);Institute for Systems and Robotics, Instituto Superior Tecnico(高等技术学院系统与机器人研究所)
Meta-training has been empirically demonstrated to be the most effective pre-training method for few-shot learning of medical image classifiers (i.e., classifiers modeled with small training sets). However, the effectiveness of meta-training relies on the availability of a reasonable number of hand-designed classification tasks, which are costly to obtain, and consequently rarely available. In this paper, we propose a new method to unsupervisedly design a large number of classification tasks to meta-train medical image classifiers. We evaluate our method on a breast dynamically contrast enhanc…
University of Sydney(悉尼大学);Royal Prince Alfred Hospital(皇家阿尔弗雷德王子医院);Shanghai Jiao Tong University(上海交通大学)
Medical image analysis using supervised deep learning methods remains problematic because of the reliance of deep learning methods on large amounts of labelled training data. Although medical imaging data repositories continue to expand there has not been a commensurate increase in the amount of annotated data. Hence, we propose a new unsupervised feature learning method that learns feature representations to then differentiate dissimilar medical images using an ensemble of different convolutional neural networks (CNNs) and K-means clustering. It jointly learns feature representations and clus…
University of Georgia(佐治亚大学);Zhongnan Hospital of Wuhan University(武汉大学中南医院);Shanghai Jiao Tong University(上海交通大学)
In this paper we consider the problem of unsupervised anomaly segmentation in medical images, which has attracted increasing attention in recent years due to the expensive pixel-level annotations from experts and the existence of a large amount of unannotated normal and abnormal image scans. We introduce a segmentation network that utilizes adversarial learning to partition an image into two cuts, with one of them falling into a reference distribution provided by the user. This Adversarial-based Selective Cutting network (ASC-Net) bridges the two domains of cluster-based deep segmentation and …
As digital medical imaging becomes more prevalent and archives increase in size, representation learning exposes an interesting opportunity for enhanced medical decision support systems. On the other hand, medical imaging data is often scarce and short on annotations. In this paper, we present an assessment of unsupervised feature learning approaches for images in the biomedical literature, which can be applied to automatic biomedical concept detection. Six unsupervised representation learning methods were built, including traditional bags of visual words, autoencoders, and generative adversar…
Peking University(北京大学);Yale University(耶鲁大学);Tencent(腾讯);University of Washington(华盛顿大学)
Medical report generation, which aims to automatically generate a long and coherent report of a given medical image, has been receiving growing research interests. Existing approaches mainly adopt a supervised manner and heavily rely on coupled image-report pairs. However, in the medical domain, building a large-scale image-report paired dataset is both time-consuming and expensive. To relax the dependency on paired data, we propose an unsupervised model Knowledge Graph Auto-Encoder (KGAE) which accepts independent sets of images and reports in training. KGAE consists of a pre-constructed know…
Building RadiologyNET: Unsupervised annotation of a large-scale multimodal medical database
University of Rijeka – Faculty of Engineering(里耶卡大学工程学院);Center for Artificial Intelligence and Cybersecurity(人工智能与网络安全中心);Medical University of Graz(格拉茨医科大学)
Distributed Deep Learning for Medical Image Denoising with Data Obfuscation
Computer Engineering Department, King Fahd University of Petroleum and Minerals(国王法赫德石油与矿物大学计算机工程系);King Fahd University of Petroleum and Minerals(国王法赫德石油与矿物大学);SDAIA-KFUPM Joint Research Center for Artificial Intelligence(SDAIA-KFUPM人工智能联合研究中心)
Canon Medical Research Europe(佳能医疗欧洲研究中心);University of Glasgow(格拉斯哥大学);University of Edinburgh(爱丁堡大学);The Alan Turing Institute(艾伦·图灵研究所)
Pathological brain lesions exhibit diverse appearance in brain images, in terms of intensity, texture, shape, size, and location. Comprehensive sets of data and annotations are difficult to acquire. Therefore, unsupervised anomaly detection approaches have been proposed using only normal data for training, with the aim of detecting outlier anomalous voxels at test time. Denoising methods, for instance classical denoising autoencoders (DAEs) and more recently emerging diffusion models, are a promising approach, however naive application of pixelwise noise leads to poor anomaly detection perform…
The Chinese University of Hong Kong(香港中文大学);Imsight Medical Technology Co. Ltd.(视见医疗科技有限公司);The Hong Kong Polytechnic University(香港理工大学)
Unsupervised domain adaptation has increasingly gained interest in medical image computing, aiming to tackle the performance degradation of deep neural networks when being deployed to unseen data with heterogeneous characteristics. In this work, we present a novel unsupervised domain adaptation framework, named as Synergistic Image and Feature Alignment (SIFA), to effectively adapt a segmentation network to an unlabeled target domain. Our proposed SIFA conducts synergistic alignment of domains from both image and feature perspectives. In particular, we simultaneously transform the appearance o…
Institute for Interdisciplinary Information Sciences, Tsinghua University(清华大学交叉信息研究院);Beihang University(北京航空航天大学);Microsoft Research(微软研究院)
3D medical image registration is of great clinical importance. However, supervised learning methods require a large amount of accurately annotated corresponding control points (or morphing), which are very difficult to obtain. Unsupervised learning methods ease the burden of manual annotation by exploiting unlabeled data without supervision. In this paper, we propose a new unsupervised learning method using convolutional neural networks under an end-to-end framework, Volume Tweening Network (VTN), for 3D medical image registration. We propose three innovative technical components: (1) An end-t…
Polytechnique Montreal(蒙特利尔综合理工大学);Pontifícia Universidade Católica do Rio Grande do Sul(南里奥格兰德天主教大学);Universite de Montreal(蒙特利尔大学)
Recent advances in deep learning methods have come to define the state-of-the-art for many medical imaging applications, surpassing even human judgment in several tasks. Those models, however, when trained to reduce the empirical risk on a single domain, fail to generalize when applied to other domains, a very common scenario in medical imaging due to the variability of images and anatomical structures, even across the same imaging modality. In this work, we extend the method of unsupervised domain adaptation using self-ensembling for the semantic segmentation task and explore multiple facets …
This paper presents a novel unsupervised segmentation method for 3D medical images. Convolutional neural networks (CNNs) have brought significant advances in image segmentation. However, most of the recent methods rely on supervised learning, which requires large amounts of manually annotated data. Thus, it is challenging for these methods to cope with the growing amount of medical images. This paper proposes a unified approach to unsupervised deep representation learning and clustering for segmentation. Our proposed method consists of two phases. In the first phase, we learn deep feature repr…
We propose a registration algorithm for 2D CT/MRI medical images with a new unsupervised end-to-end strategy using convolutional neural networks. The contributions of our algorithm are threefold: (1) We transplant traditional image registration algorithms to an end-to-end convolutional neural network framework, while maintaining the unsupervised nature of image registration problems. The image-to-image integrated framework can simultaneously learn both image features and transformation matrix for registration. (2) Training with additional data without any label can further improve the registra…
Medical image registration and segmentation are critical tasks for several clinical procedures. Manual realisation of those tasks is time-consuming and the quality is highly dependent on the level of expertise of the physician. To mitigate that laborious task, automatic tools have been developed where the majority of solutions are supervised techniques. However, in medical domain, the strong assumption of having a well-representative ground truth is far from being realistic. To overcome this challenge, unsupervised techniques have been investigated. However, they are still limited in performan…
We propose a novel deep learning model for classifying medical images in the setting where there is a large amount of unlabelled medical data available, but labelled data is in limited supply. We consider the specific case of classifying skin lesions as either malignant or benign. In this setting, the proposed approach -- the semi-supervised, denoising adversarial autoencoder -- is able to utilise vast amounts of unlabelled data to learn a representation for skin lesions, and small amounts of labelled data to assign class labels based on the learned representation. We analyse the contributions…
School of Computer Science, University of Sydney(悉尼大学计算机科学学院);Royal Prince Alfred Hospital(皇家阿尔弗雷德王子医院);Sydney Medical School, University of Sydney(悉尼大学悉尼医学院);Med-X Research Institute, Shanghai Jiao Tong University(上海交通大学Med-X研究院)
The availability of large-scale annotated image datasets and recent advances in supervised deep learning methods enable the end-to-end derivation of representative image features that can impact a variety of image analysis problems. Such supervised approaches, however, are difficult to implement in the medical domain where large volumes of labelled data are difficult to obtain due to the complexity of manual annotation and inter- and intra-observer variability in label assignment. We propose a new convolutional sparse kernel network (CSKN), which is a hierarchical unsupervised feature learning…
Local discriminative representation is needed in many medical image analysis tasks such as identifying sub-types of lesion or segmenting detailed components of anatomical structures. However, the commonly applied supervised representation learning methods require a large amount of annotated data, and unsupervised discriminative representation learning distinguishes different images by learning a global feature, both of which are not suitable for localized medical image analysis tasks. In order to avoid the limitations of these two methods, we introduce local discrimination into unsupervised re…
We explore different curriculum learning methods for training convolutional neural networks on the task of deformable pairwise 3D medical image registration. To the best of our knowledge, we are the first to attempt to improve performance by training medical image registration models using curriculum learning, starting from an easy training setup in the first training stages, and gradually increasing the complexity of the setup. On the one hand, we consider two existing curriculum learning approaches, namely curriculum dropout and curriculum by smoothing. On the other hand, we propose a novel …
University of Sydney(悉尼大学);Royal Prince Alfred Hospital(阿尔弗雷德王子医院);Shanghai Jiao Tong University(上海交通大学)
The accuracy and robustness of image classification with supervised deep learning are dependent on the availability of large-scale, annotated training data. However, there is a paucity of annotated data available due to the complexity of manual annotation. To overcome this problem, a popular approach is to use transferable knowledge across different domains by: 1) using a generic feature extractor that has been pre-trained on large-scale general images (i.e., transfer-learned) but which not suited to capture characteristics from medical images; or 2) fine-tuning generic knowledge with a relati…
Image denoising is a prerequisite for downstream tasks in many fields. Low-dose and photon-counting computed tomography (CT) denoising can optimize diagnostic performance at minimized radiation dose. Supervised deep denoising methods are popular but require paired clean or noisy samples that are often unavailable in practice. Limited by the independent noise assumption, current unsupervised denoising methods cannot process correlated noises as in CT images. Here we propose the first-of-its-kind similarity-based unsupervised deep denoising approach, referred to as Noise2Sim, that works in a non…