Abstract:MR imaging will play a very important role in radiotherapy treatment planning for segmentation of tumor volumes and organs. However, the use of MR-based radiotherapy is limited because of the high cost and the increased use of metal implants such as cardiac pacemakers and artificial joints in aging society. To improve the accuracy of CT-based radiotherapy planning, we propose a synthetic approach that translates a CT image into an MR image using paired and unpaired training data. In contrast to the current synthetic methods for medical images, which depend on sparse pairwise-aligned data or plentiful unpaired data, the proposed approach alleviates the rigid registration challenge of paired training and overcomes the context-misalignment problem of the unpaired training. A generative adversarial network was trained to transform 2D brain CT image slices into 2D brain MR image slices, combining adversarial loss, dual cycle-consistent loss, and voxel-wise loss. The experiments were analyzed using CT and MR images of 202 patients. Qualitative and quantitative comparisons against independent paired training and unpaired training methods demonstrate the superiority of our approach.