# R2MF-Net: A Recurrent Residual Multi-Path Fusion Network for Robust Multi-directional Spine X-ray Segmentation

arXiv: https://arxiv.org/abs/2512.07576 · HTML: https://mlsanity.com/paper/2512.07576/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 16 of its 26 references that are in the map.
- First posted on arXiv 8 Dec 2025.

## Builds on (most cited first, 16 of 16)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [Encoder-Decoder with Atrous Separable Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1802.02611/) (2018)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [Image Segmentation Using Deep Learning: A Survey](https://mlsanity.com/paper/2001.05566/) (2020)
- [The Importance of Skip Connections in Biomedical Image Segmentation](https://mlsanity.com/paper/1608.04117/) (2016)
- [Concurrent Spatial and Channel Squeeze & Excitation in Fully Convolutional Networks](https://mlsanity.com/paper/1803.02579/) (2018)
- [HarDNet: A Low Memory Traffic Network](https://mlsanity.com/paper/1909.00948/) (2019)
- [Fully Automatic Segmentation of Lumbar Vertebrae from CT Images using Cascaded 3D Fully Convolutional Networks](https://mlsanity.com/paper/1712.01509/) (2017)

## Abstract (arXiv)

Accurate segmentation of spinal structures in X-ray images is a prerequisite for quantitative scoliosis assessment, including Cobb angle measurement, vertebral translation estimation and curvature classification. In routine practice, clinicians acquire coronal, left-bending and right-bending radiographs to jointly evaluate deformity severity and spinal flexibility. However, the segmentation step remains heavily manual, time-consuming and non-reproducible, particularly in low-contrast images and in the presence of rib shadows or overlapping tissues. To address these limitations, this paper proposes R2MF-Net, a recurrent residual multi-path encoder--decoder network tailored for automatic segmentation of multi-directional spine X-ray images. The overall design consists of a coarse segmentation network and a fine segmentation network connected in cascade. Both stages adopt an improved Inception-style multi-branch feature extractor, while a recurrent residual jump connection (R2-Jump) module is inserted into skip paths to gradually align encoder and decoder semantics. A multi-scale cross-stage skip (MC-Skip) mechanism allows the fine network to reuse hierarchical representations from multiple decoder levels of the coarse network, thereby strengthening the stability of segmentation across imaging directions and contrast conditions. Furthermore, a lightweight spatial-channel squeeze-and-excitation block (SCSE-Lite) is employed at the bottleneck to emphasize spine-related activations and suppress irrelevant structures and background noise. We evaluate R2MF-Net on a clinical multi-view radiograph dataset comprising 228 sets of coronal, left-bending and right-bending spine X-ray images with expert annotations.