Low-dose computed tomography (CT) image denoising is crucial in medical image computing. Recent years have been remarkable improvement in deep learning-based methods for this task. However, training deep denoising neural networks requires low-dose and normal-dose CT image pairs, which are difficult to obtain in the clinic settings. To address this challenge, we propose a novel fully unsupervised method for low-dose CT image denoising, which is based on denoising diffusion probabilistic model -- a powerful generative model. First, we train an unconditional denoising diffusion probabilistic model capable of generating high-quality normal-dose CT images from random noise. Subsequently, the probabilistic priors of the pre-trained diffusion model are incorporated into a Maximum A Posteriori (MAP) estimation framework for iteratively solving the image denoising problem. Our method ensures the diffusion model produces high-quality normal-dose CT images while keeping the image content consistent with the input low-dose CT images. We evaluate our method on a widely used low-dose CT image denoising benchmark, and it outperforms several supervised low-dose CT image denoising methods in terms of both quantitative and visual performance.
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