In accordance with the teachings described herein, systems and methods are provided for generating a contour for a medical image. The system may include a contour synthesis engine that is configured to receive a plurality of contours for a medical image, the plurality of contours identifying at least one object within the medical image. The contour synthesis engine may be further configured to synthesize a combined contour from the plurality of contours by selecting portions of the plurality of contours based on one or more pre-defined contour combination criterion, the one or more pre-defined contour combination criterion including a designated number of contour overlaps such that any region where at least the designated number of contours are overlapping is included in the combined contour. The system may also include a graphical user interface configured to display an overlay of the plurality of contours and the combined contour on the medical image, and to receive user input to modify the combined contour by adding an additional region from the plurality of contours.