# LatXGen: Towards Radiation-Free and Accurate Quantitative Analysis of Sagittal Spinal Alignment Via Cross-Modal Radiographic View Synthesis

arXiv: https://arxiv.org/abs/2509.24165 · HTML: https://mlsanity.com/paper/2509.24165/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 39 references that are in the map.
- First posted on arXiv 29 Sep 2025.

## Builds on (most cited first, 11 of 11)

- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [Spatial Transformer Networks](https://mlsanity.com/paper/1506.02025/) (2015)
- [High-Resolution Image Synthesis and Semantic Manipulation with Conditional GANs](https://mlsanity.com/paper/1711.11585/) (2017)
- [Resolution-robust Large Mask Inpainting with Fourier Convolutions](https://mlsanity.com/paper/2109.07161/) (2021)
- [X2CT-GAN: Reconstructing CT from Biplanar X-Rays with Generative Adversarial Networks](https://mlsanity.com/paper/1905.06902/) (2019)
- [Structure-Aware Sparse-View X-ray 3D Reconstruction](https://mlsanity.com/paper/2311.10959/) (2023)
- [MedNeRF: Medical Neural Radiance Fields for Reconstructing 3D-aware CT-Projections from a Single X-ray](https://mlsanity.com/paper/2202.01020/) (2022)
- [Radiative Gaussian Splatting for Efficient X-ray Novel View Synthesis](https://mlsanity.com/paper/2403.04116/) (2024)
- [Generating Synthetic X-ray Images of a Person from the Surface Geometry](https://mlsanity.com/paper/1805.00553/) (2018)
- [XraySyn: Realistic View Synthesis From a Single Radiograph Through CT Priors](https://mlsanity.com/paper/2012.02407/) (2020)
- [Structural Attention: Rethinking Transformer for Unpaired Medical Image Synthesis](https://mlsanity.com/paper/2406.18967/) (2024)

## Abstract (arXiv)

Adolescent Idiopathic Scoliosis (AIS) is a complex three-dimensional spinal deformity, and accurate morphological assessment requires evaluating both coronal and sagittal alignment. While previous research has made significant progress in developing radiation-free methods for coronal plane assessment, reliable and accurate evaluation of sagittal alignment without ionizing radiation remains largely underexplored. To address this gap, we propose LatXGen, a novel generative framework that synthesizes realistic lateral spinal radiographs from posterior Red-Green-Blue and Depth (RGBD) images of unclothed backs. This enables accurate, radiation-free estimation of sagittal spinal alignment. LatXGen tackles two core challenges: (1) inferring sagittal spinal morphology changes from a lateral perspective based on posteroanterior surface geometry, and (2) performing cross-modality translation from RGBD input to the radiographic domain. The framework adopts a dual-stage architecture that progressively estimates lateral spinal structure and synthesizes corresponding radiographs. To enhance anatomical consistency, we introduce an attention-based Fast Fourier Convolution (FFC) module for integrating anatomical features from RGBD images and 3D landmarks, and a Spatial Deformation Network (SDN) to model morphological variations in the lateral view. Additionally, we construct the first large-scale paired dataset for this task, comprising 3,264 RGBD and lateral radiograph pairs. Experimental results demonstrate that LatXGen produces anatomically accurate radiographs and outperforms existing GAN-based methods in both visual fidelity and quantitative metrics. This study offers a promising, radiation-free solution for sagittal spine assessment and advances comprehensive AIS evaluation.