Denoising and contrast enhancement play key roles in optimizing the trade-off between image quality and X-ray dose. However, these tasks present multiple challenges raised by noise level, low visibility of fine anatomical structures, heterogeneous conditions due to different exposure parameters, and patient characteristics. This work proposes a new method to address these challenges. We first introduce a patch-based filter adapted to the properties of the noise corrupting X-ray images. The filtered images are then used as oracles to define non parametric noise containment maps that, when applied in a multiscale contrast enhancement framework, allow optimizing the trade-off between improvement of the visibility of anatomical structures and noise reduction. A significant amount of tests on both phantoms and clinical images has shown that the proposed method is better suited than others for visual inspection for diagnosis, even when compared to an algorithm used to process low dose images in clinical routine.