While medical image segmentation is an important task for computer aided diagnosis, the high expertise requirement for pixelwise manual annotations makes it a challenging and time consuming task. Since conventional data augmentations do not fully represent the underlying distribution of the training set, the trained models have varying performance when tested on images captured from different sources. Most prior work on image synthesis for data augmentation ignore the interleaved geometric relationship between different anatomical labels. We propose improvements over previous GAN-based medical image synthesis methods by learning the relationship between different anatomical labels. We use a weakly supervised segmentation method to obtain pixel level semantic label map of images which is used learn the intrinsic relationship of geometry and shape across semantic labels. Latent space variable sampling results in diverse generated images from a base image and improves robustness. We use the synthetic images from our method to train networks for segmenting COVID-19 infected areas from lung CT images. The proposed method outperforms state-of-the-art segmentation methods on a public dataset. Ablation studies also demonstrate benefits of integrating geometry and diversity.
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