Null-Space Diffusion Restoration with Adaptive Uncertainty-Guided Fusion for Ultrasound Speckle Reduction

Ultrasound B-mode imaging commonly suffers from speckle noise and artifacts, requiring a delicate balance between contrast, resolution, and preservation of anatomical structures. Although recently developed despeckling methods have achieved some progress, supervised learning approaches remain fundamentally limited by the ground truth paradox, which arises from the absence of noise-free, ground truth reference images in in vivo scenarios. Existing unsupervised diffusion-based methods typically enforce data consistency directly in the nonlinear log-compressed domain, which can disproportionately amplify background artifacts when mapped back to the envelope domain. To overcome these limitations, we propose an uncertainty-guided null-space diffusion (UGNS) framework, a novel label-free solution that enforces consistency correction on a stabilized positive-envelope proxy obtained via inverse log compression. The proposed UGNS introduces several technical novelties: (a) extraction of a structural prior in the stabilized envelope domain to produce a robust signal envelope that preserves anatomical structure, (b) development of an adaptive range-null reconstruction mechanism that uses an adaptive weight mask to preserve tissue regions via range-space projection, and (c) introduction of uncertainty-guided fusion in an adaptive way to mitigate sampling variability. Extensive and comparative experiments were conducted using the PICMUS benchmark and in vivo datasets. The results demonstrate that UGNS achieves competitive generalized contrast-to-noise ratio (gCNR) values across diverse datasets. In addition, it is successfully validated that UGNS effectively suppresses speckle noise while preserving fine spatial resolution. Code is available at https://github.com/yousirong/UGNS.git.