Synthetic Atrophy for Longitudinal Cortical Surface Analyses

In the fields of longitudinal cortical segmentation and surface-based cortical thickness (CT) measurement, difficulty in assessing accuracy remains a substantial limitation due to the inability of experimental validation against ground truth. Although methods have been developed to create synthetic datasets for these purposes, none provide a robust mechanism for measuring exact thickness changes with surface-based approaches. This work presents a registration-based technique for inducing synthetic cortical atrophy to create a longitudinal ground truth dataset specifically designed to address this gap in surface-based accuracy validation techniques. Across the entire brain, our method can induce up to between 0.8 and 2.5 mm of localized cortical atrophy in a given gyrus depending on the region's original thickness. By calculating the image deformation to induce this atrophy at 400% of the original resolution in each direction, we can induce a sub-voxel resolution amount of atrophy while minimizing partial volume effects. We also show that cortical segmentations of synthetically atrophied images exhibit similar segmentation error to those obtained from images of naturally atrophied brains. Importantly, our method relies exclusively on publicly available software and datasets.