Diffusion MRI tractography is the most widely used macroscale method for mapping connectomes in vivo. However, tractography is prone to various errors and biases, and thus tractography-derived connectomes require careful validation. Here, we critically review studies that have developed or utilized phantoms and tracer maps to validate tractography-derived connectomes, either quantitatively or qualitatively. We identify key factors impacting connectome reconstruction accuracy, including streamline seeding, propagation and filtering methods, and consider the strengths and limitations of state-of-the-art connectome phantoms and associated validation studies. These studies demonstrate the inherent limitations of current fiber orientation models and tractography algorithms and their impact on connectome reconstruction accuracy. Reconstructing connectomes with both high sensitivity and high specificity is challenging, given that some tractography methods can generate an abundance of spurious connections, while others can overlook genuine fiber bundles.We argue that streamline filtering can minimize spurious connections and potentially improve the biological plausibility of connectomes derived from tractography. We find that algorithmic choices such as the tractography seeding methodology, angular threshold, and streamline propagation method can substantially impact connectome reconstruction accuracy. Hence, careful application of tractography is necessary to reconstruct accurate connectomes. Improvements in diffusion MRI acquisition techniques will not necessarily overcome current tractography limitations without accompanying modeling and algorithmic advances.
| INTRODUCTIONDiffusion-weighted MRI (dMRI) can be used to non-invasively infer microstructural properties of the brain. Tractography is a reconstruction method based on dMRI to compute the trajectories of white matter (WM) fiber bundles. The primary objective of tractography is to reconstruct non-invasively WM fiber bundles from dMRI. More recently, tractography has been used to map the human structural connectome 1-3 i.e. a comprehensive network description of WM fiber bundles connecting pairs of gray matter (GM) regions (also referred to as structural connectivity).Structural connectomes model the physical links between brain regions, whereas functional connectomes represent the network of functionally connected regions. These connectomes are a static representation of the brain that could change over time. 4,5 When referring to connectomes in this review, we specifically mean structural connectomes mapped with tractography.Generally, connectome mapping using tractography is a five-step process involving (1) dMRI acquisition, (2) segmenting the cortex into regions of interest (ROIs)-cortical parcellation, (3) diffusion/fiber orientation estimation, (4) streamline generation using tractography, and