The accurate segmentation of guidewires in interventional cardiac fluoroscopy videos is crucial for computer-aided navigation tasks. Although deep learning methods have demonstrated high accuracy and robustness in wire segmentation, they require substantial annotated datasets for generalizability, underscoring the need for extensive labeled data to enhance model performance. To address this challenge, we propose the Segmentation-guided Frame-consistency Video Diffusion Model (SF-VD) to generate large collections of labeled fluoroscopy videos, augmenting the training data for wire segmentation networks. SF-VD leverages videos with limited annotations by independently modeling scene distribution and motion distribution. It first samples the scene distribution by generating 2D fluoroscopy images with wires positioned according to a specified input mask, and then samples the motion distribution by progressively generating subsequent frames, ensuring frame-to-frame coherence through a frame-consistency strategy. A segmentation-guided mechanism further refines the process by adjusting wire contrast, ensuring a diverse range of visibility in the synthesized image. Evaluation on a fluoroscopy dataset confirms the superior quality of the generated videos and shows significant improvements in guidewire segmentation.

In the sphere of Cone Beam Computed Tomography (CBCT), acquiring X-ray projections from sufficient angles is indispensable for traditional image reconstruction methods to accurately reconstruct 3D anatomical intricacies. However, this acquisition procedure for the linear accelerator-mounted CBCT systems in radiotherapy takes approximately one minute, impeding its use for ultra-fast intra-fractional motion monitoring during treatment delivery. To address this challenge, we introduce the Patient-specific Cycle-domain Geometric-integrated Denoising Diffusion Probabilistic Model (CG-DDPM). This model aims to leverage patient-specific priors from patient's CT/4DCT images, which are acquired for treatment planning purposes, to reconstruct 3D CBCT from a single-view 2D CBCT projection of any arbitrary angle during treatment, namely single-view reconstructed CBCT (svCBCT). The CG-DDPM framework encompasses a dual DDPM structure: the Projection-DDPM for synthesizing comprehensive full-view projections and the CBCT-DDPM for creating CBCT images. A key innovation is our Cycle-Domain Geometry-Integrated (CDGI) method, incorporating a Cone Beam X-ray Geometric Transformation Module (GTM) to ensure precise, synergistic operation between the dual DDPMs, thereby enhancing reconstruction accuracy and reducing artifacts. Evaluated in a study involving 37 lung cancer patients, the method demonstrated its ability to reconstruct CBCT not only from simulated X-ray projections but also from real-world data. The CG-DDPM significantly outperforms existing V-shape convolutional neural networks (V-nets), Generative Adversarial Networks (GANs), and DDPM methods in terms of reconstruction fidelity and artifact minimization. This was confirmed through extensive voxel-level, structural, visual, and clinical assessments. The capability of CG-DDPM to generate high-quality reconstructed CBCT from a single-view projection at any arbitrary angle using a single model opens the door for ultra-fast, in-treatment volumetric imaging. This is especially beneficial for radiotherapy at motion-associated cancer sites and image-guided interventional procedures.