Low-dose CT (LDCT) images have been widely applied in the medical imaging field due to the potential risk of exposing patients to X-ray radiations. Given the fact that reducing the radiation dose may result in increased noise and artifacts, methods that can eliminate the noise and artifacts in the LDCT image have drawn increasing attentions and produced impressive results over the past decades. However, recent proposed methods mostly suffer from noise remaining, over-smoothing structures or false lesions derived from noise. In this paper, we propose a generative adversarial network (GAN) with novel architecture and loss function for restoring the LDCT image. Firstly, the inception-residual block and residual mapping are incoporated in the U-Net structure. The modified U-Net is applied as the generator of the GAN network so that the noise feature can be eliminated during the forward propagation. Secondly, a novel multi-level joint discriminator is designed by concatenating multiple convolutional neural networks (CNNs) where the output of each deconvolutional layer in the generator is compared with the corresponding down-sampled ground truth image. The adversarial training can be sensitive to noise and artifacts in different scales with this discriminator. Thirdly, we novely define a loss function consisting of the least square adversarial loss, VGG based perceptual loss, MSE based pixel loss and the noise loss, so that the differences in pixel, visual perception and noise distribution are comprehensively considered to optimize the network. Experimental results on both simulated and official simulated clinical images have demonstrated that the proposed method can provide superior performance to the state-of-the-art methods in noise removal, structure preservation and false lesions elimination. INDEX TERMS Low-dose CT image denoising, deep learning, generative adversarial network, inception block, residual mapping, joint loss.