Low-dose computed tomography (LDCT) has become the technology of choice for diagnostic medical imaging, given its lower radiation dose compared to standard CT, despite increasing image noise and potentially affecting diagnostic accuracy. To address this, advanced deep learning-based LDCT denoising algorithms have been developed, primarily using Convolutional Neural Networks (CNNs) or Transformer Networks with the Unet architecture. This architecture enhances image detail by integrating feature maps from the encoder and decoder via skip connections. However, current methods often overlook enhancements to the Unet architecture itself, focusing instead on optimizing encoder and decoder structures. This approach can be problematic due to the significant differences in feature map characteristics between the encoder and decoder, where simple fusion strategies may not effectively reconstruct images.In this paper, we introduce WiTUnet, a novel LDCT image denoising method that utilizes nested, dense skip pathways instead of traditional skip connections to improve feature integration. WiTUnet also incorporates a windowed Transformer structure to process images in smaller, non-overlapping segments, reducing computational load. Additionally, the integration of a Local Image Perception Enhancement (LiPe) module in both the encoder and decoder replaces the standard multi-layer perceptron (MLP) in Transformers, enhancing local feature capture and representation. Through extensive experimental comparisons, WiTUnet has demonstrated superior performance over existing methods in key metrics such as Peak Signal-to-Noise Ratio (PSNR), Structural Similarity (SSIM), and Root Mean Square Error (RMSE), significantly improving noise removal and image quality.
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