Automated segmentation can assist radiotherapy treatment planning by saving manual contouring efforts and reducing intra-observer and inter-observer variations. The recent development of deep learning approaches has revoluted medical data processing, including semantic segmentation, by dramatically improving performance. However, training effective deep learning models usually require a large amount of high-quality labeled data, which are often costly to collect. We developed a novel semi-supervised adversarial deep learning approach for 3D pelvic CT image semantic segmentation. Unlike supervised deep learning methods, the new approach can utilize both annotated and un-annotated data for training. It generates un-annotated synthetic data by a data augmentation scheme using generative adversarial networks (GANs). We applied the new approach to segmenting multiple organs in male pelvic CT images, where CT images without annotations and GAN-synthesized un-annotated images were used in semi-supervised learning. Experimental results, evaluated by three metrics (Dice similarity coefficient, average Hausdorff distance, and average surface Hausdorff distance), showed that the new method achieved either comparable performance with substantially fewer annotated images or better performance with the same amount of annotated data, outperforming the existing state-of-the-art methods.
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