Systems and methods for generating synthesized images are provided. An input medical image of a patient in a first domain is received. A synthesized image in a second domain is generated from the input medical image of the patient in the first domain using a first generator. The first generator is trained based on a comparison between segmentation results of a training image in the first domain from a first segmentor and segmentation results of a synthesized training image in the second domain from a second segmentor. The synthesized training image in the second domain is generated by the first generator from the training image in the first domain. The synthesized image in the second domain is output.