Photon counting CT (PCCT) acquires spectral measurements and enables generation of material decomposition (MD) images that provide distinct advantages in various clinical situations. However, noise amplification is observed in MD images, and denoising is typically applied. Clean or high-quality references are rare in clinical scans, often making supervised learning (Noise2Clean) impractical. Noise2Noise is a self-supervised counterpart, using noisy images and corresponding noisy references with zero-mean, independent noise. PCCT counts transmitted photons separately, and raw measurements are assumed to follow a Poisson distribution in each energy bin, providing the possibility to create noise-independent pairs. The approach is to use binomial selection to split the counts into two low-dose scans with independent noise. We prove that the reconstructed spectral images inherit the noise independence from counts domain through noise propagation analysis and also validated it in numerical simulation and experimental phantom scans. The method offers the flexibility to split measurements into desired dose levels while ensuring the reconstructed images share identical underlying features, thereby strengthening the model's robustness for input dose levels and capability of preserving fine details. In both numerical simulation and experimental phantom scans, we demonstrated that Noise2Noise with binomial selection outperforms other common self-supervised learning methods based on different presumptive conditions.
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