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An organ segmentation method that can generalize to unseen contrasts and scanner settings can significantly reduce the need for retraining of deep learning models. Domain Generalization (DG) aims to achieve this goal. However, most DG methods for segmentation require training data from multiple domains during training. We propose a novel adversarial domain generalization method for organ segmentation trained on data from a single domain. We synthesize the new domains via learning an adversarial domain synthesizer (ADS) and presume that the synthetic domains cover a large enough area of plausible distributions so that unseen domains can be interpolated from synthetic domains. We propose a mutual information regularizer to enforce the semantic consistency between images from the synthetic domains, which can be estimated by patch-level contrastive learning. We evaluate our method for various organ segmentation for unseen modalities, scanning protocols, and scanner sites. 

Unpaired image-to-image translation (I2I) is an ill-posed problem, as an infinite number of translation functions can map the source domain distribution to the target distribution. Therefore, much effort has been put into designing suitable constraints, e.g., cycle consistency (CycleGAN), geometry consistency (GCGAN), and contrastive learning-based constraints (CUTGAN), that help better pose the problem. However, these well-known constraints have limitations: (1) they are either too restrictive or too weak for specific I2I tasks; (2) these methods result in content distortion when there is a significant spatial variation between the source and target domains. This paper proposes a universal regularization technique called maximum spatial perturbation consistency (MSPC), which enforces a spatial perturbation function (T) and the translation operator (G) to be commutative (i.e., T \circ G = G \circ T ). In addition, we introduce two adversarial training components for learning the spatial perturbation function. The first one lets T compete with G to achieve maximum perturbation. The second one lets G and T compete with discriminators to align the spatial variations caused by the change of object size, object distortion, background interruptions, etc. Our method outperforms the state-of-the-art methods on most I2I benchmarks. We also introduce a new benchmark, namely the front face to profile face dataset, to emphasize the underlying challenges of I2I for real-world applications. We finally perform ablation experiments to study the sensitivity of our method to the severity of spatial perturbation and its effectiveness for distribution alignment.