Filter2Noise: A Framework for Interpretable and Zero-Shot Low-Dose CT Image Denoising

Noise in low-dose computed tomography (LDCT) can obscure important diagnostic details. While deep learning offers powerful denoising, supervised methods require impractical paired data, and self-supervised alternatives often use opaque, parameter-heavy networks that limit clinical trust. We propose Filter2Noise (F2N), a novel self-supervised framework for interpretable, zero-shot denoising from a single LDCT image. Instead of a black-box network, its core is an Attention-Guided Bilateral Filter, a transparent, content-aware mathematical operator. A lightweight attention module predicts spatially varying filter parameters, making the process transparent and allowing interactive radiologist control. To learn from a single image with correlated noise, we introduce a multi-scale self-supervised loss coupled with Euclidean Local Shuffle (ELS) to disrupt noise patterns while preserving anatomical integrity. On the Mayo Clinic LDCT Challenge, F2N achieves state-of-the-art results, outperforming competing zero-shot methods by up to 3.68 dB in PSNR. It accomplishes this with only 3.6k parameters, orders of magnitude fewer than competing models, which accelerates inference and simplifies deployment. By combining high performance with transparency, user control, and high parameter efficiency, F2N offers a trustworthy solution for LDCT enhancement. We further demonstrate its applicability by validating it on clinical photon-counting CT data. Code is available at: https://github.com/sypsyp97/Filter2Noise.