Anatomically informed multi-level fiber tractography

Diffusion weighted MR imaging can assist preoperative planning by reconstructing the trajectory of eloquent fiber pathways. A common task is the delineation of the corticospinal tract in its full extent because lesions to this bundle can severely affect the quality of life. However, this is challenging as existing tractography algorithms typically produce either incomplete results or multiple false-positive tracts. In this work, we suggest a novel approach to fiber tractography that reconstructs multi-level structures by progressively taking into account previously unused fiber orientations. Anatomical priors are used in order to minimize the number of false-positive pathways. The devised method was evaluated on synthetic data with different noise levels. Additionally, it was tested on in-vivo data by reconstructing the corticospinal tract and it was compared to conventional deterministic and probabilistic approaches. The corticospinal tract reconstructed by our method includes lateral projections that could not be observed with deterministic methods, while avoiding spurious tracts reconstructed by probabilistic tractography. Furthermore, the proposed algorithm preserves the neuroanatomical topology of the pathways to a larger extent as compared to probabilistic tractography. ### Competing Interest Statement The authors have declared no competing interest.