  Automatic parsing of anatomical objects in X-ray images is critical to many
clinical applications in particular towards image-guided invention and workflow
automation. Existing deep network models require a large amount of labeled
data. However, obtaining accurate pixel-wise labeling in X-ray images relies
heavily on skilled clinicians due to the large overlaps of anatomy and the
complex texture patterns. On the other hand, organs in 3D CT scans preserve
clearer structures as well as sharper boundaries and thus can be easily
delineated. In this paper, we propose a novel model framework for learning
automatic X-ray image parsing from labeled CT scans. Specifically, a Dense
Image-to-Image network (DI2I) for multi-organ segmentation is first trained on
X-ray like Digitally Reconstructed Radiographs (DRRs) rendered from 3D CT
volumes. Then we introduce a Task Driven Generative Adversarial Network
(TD-GAN) architecture to achieve simultaneous style transfer and parsing for
unseen real X-ray images. TD-GAN consists of a modified cycle-GAN substructure
for pixel-to-pixel translation between DRRs and X-ray images and an added
module leveraging the pre-trained DI2I to enforce segmentation consistency. The
TD-GAN framework is general and can be easily adapted to other learning tasks.
In the numerical experiments, we validate the proposed model on 815 DRRs and
153 topograms. While the vanilla DI2I without any adaptation fails completely
on segmenting the topograms, the proposed model does not require any topogram
labels and is able to provide a promising average dice of 85% which achieves
the same level accuracy of supervised training (88%).
