Suggestions for processing DICOM images

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I have a series of DICOM images that I need to segment. The problem is that they have a lot of despeckle noise and same intensities among different areas of the soft tissue that makes it difficult for any segmentation algorithm to work.
Can you suggest preprocessing methods so images become more contrast, with less noise and easily segmented?
I attach a sample of the images I want to segment.
Waiting for your suggestions.

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Image Analyst
Image Analyst il 23 Dic 2018
I'm sure ultrasound noise is a common topic of research.
Go here to find papers on the subject: Vision Bibliography
You should be able to find something there. For example, just a small sampling:
20.12.3 Ultrasound, Ultrasonic, Speckle Removal, Analysis
Adaptive speckle reduction filter for log-compressed B-scan images,
MedImg(15), No. 6, December 1996, pp. 802-813.
Detection of lines and boundaries in speckle images-application to medical ultrasound,
MedImg(18), No. 2, February 1999, pp. 126-136.
Earlier:
Ultrasound speckle reduction by directional median filtering,
ICIP95(I: 358-361).
Earlier:
Edge detection in ultrasound speckle noise,
ICIP94(III: 304-308).

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