Uncertainty-Propelled Physics-MAE Fusion for Self-Supervised Diffusion-Weighted Image Denoising

Abstract The inherently low signal-to-noise ratio (SNR) in diffusion-weighted (DW) imaging fundamentally impedes precise tissue microstructure characterization, rendering effective noise suppression a persistent challenge. Existing denoising methods frequently suffer from over-smoothing or distortion of microstructure information when handling spatially correlated or severe noise. To address these limitations, we propose UP2-MAE fusion model, a self-supervised DWI denoising method based on Uncertainty-Propelled Physics and Masked Auto-Encoder (MAE) fusion. This framework integrates two complementary branches: one leverages MAE to suppress noise through local context modeling, while the other constructs uncorrelated noisy pairs using diffusion tensor imaging (DTI) physics and denoises them via a Noise2Noise approach, which can preserve texture details by exploiting directional relationships across diffusion encoding directions. To fully integrate the strengths of both branches, an uncertainty-propelled fusion strategy based on maximum likelihood estimation is proposed to derive the final denoised output. In addition, to further promote the performance, uncertainty-guided reconstruction and consistency loss are presented. Evaluations against state-of-the-art denoising methods on both simulated and acquired DW datasets confirm the efficacy of our approach.