Deep learning in medical imaging often requires large-scale, high-quality data or initiation with suitably pre-trained weights. However, medical datasets are limited by data availability, domain-specific knowledge, and privacy concerns, and the creation of large and diverse radiologic databases like RadImageNet is highly resource-intensive. To address these limitations, we introduce RadImageGAN, the first multi-modal radiologic data generator, which was developed by training StyleGAN-XL on the real RadImageNet dataset of 102,774 patients. RadImageGAN can generate high-resolution synthetic medical imaging datasets across 12 anatomical regions and 130 pathological classes in 3 modalities. Furthermore, we demonstrate that RadImageGAN generators can be utilized with BigDatasetGAN to generate multi-class pixel-wise annotated paired synthetic images and masks for diverse downstream segmentation tasks with minimal manual annotation. We showed that using synthetic auto-labeled data from RadImageGAN can significantly improve performance on four diverse downstream segmentation datasets by augmenting real training data and/or developing pre-trained weights for fine-tuning. This shows that RadImageGAN combined with BigDatasetGAN can improve model performance and address data scarcity while reducing the resources needed for annotations for segmentation tasks.