Low-dose CT images are essential for reducing radiation exposure in cancer screening, pediatric imaging, and longitudinal monitoring protocols, but their quality is often degraded by noise from low-dose acquisition, patient motion, or scanner limitations, affecting both clinical interpretation and downstream analysis. Traditional filtering approaches often over-smooth and lose fine anatomical details, while deep learning methods, including CNNs, GANs, and transformers, may struggle to preserve such details or require large, computationally expensive models, limiting clinical practicality. We propose PatchDenoiser, a lightweight, energy-efficient multi-scale patch-based denoising framework. It decomposes denoising into local texture extraction and global context aggregation, fused via a spatially aware patch fusion strategy. This design enables effective noise suppression while preserving fine structural and anatomical details. PatchDenoiser is ultra-lightweight, with far fewer parameters and lower computational complexity than CNN, GAN, and transformer based denoisers. On the 2016 Mayo Low-Dose CT dataset, PatchDenoiser consistently outperforms state-of-the-art CNN- and GAN-based methods in PSNR and SSIM. It is robust to variations in slice thickness, reconstruction kernels, and HU windows, generalizes across scanners without fine-tuning, and reduces parameters by ~9x and energy consumption per inference by ~27x compared with conventional CNN denoisers. PatchDenoiser thus provides a practical, scalable, and computationally efficient solution for medical image denoising, balancing performance, robustness, and clinical deployability.

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