Novel Methods for Catheter and Guidewire Segmentation in X-ray Fluoroscopy under a Federated Learning Setting

Endovascular procedures rely on real-time manipulation of thin instruments, catheters and guidewires, under X-ray fluoroscopy guidance, where accurate visual analysis is essential for procedural safety. Learning-based methods are constrained by structural complexity, data scarcity, and privacy regulations precluding centralised training across institutions. This thesis presents a structure-aware federated learning framework for catheter and guidewire analysis, with four contributions evaluated on real-animal and phantom data. A benchmark dataset, CathAction, is introduced for catheterisation analysis, with over 600,000 annotated frames and 40,000 segmentation masks. A shape-sensitive loss transforms masks into signed distance maps compared in a structural feature space, improving Dice coefficient by up to 2.9 points across five backbones. This is extended to federated learning with shape-sensitive loss, preserving geometric consistency under heterogeneous client data and outperforming federated averaging by up to three points in mean intersection-over-union as clients scale from four to eight. Federated learning with projected gradient descent adds adversarial optimisation, raising mean intersection-over-union by over ten points on real-animal data. Finally, a structure-aware diffusion framework synthesises catheter and guidewire video sequences, combining structural supervision with a domain-adaptive reconstruction objective, reducing Frechet video distance over a strong baseline while maintaining visual fidelity. Incorporating synthetic sequences into federated training raises the Dice score from 44 to 51 percent under data scarcity, with gains across four held-out sites. Together, these contributions advance privacy-preserving catheter and guidewire analysis, supporting collaborative training without centralising patient data or large amounts of manual annotation.