TractEM: Fast Protocols for Whole Brain Deterministic Tractography-Based White Matter Atlas

Reproducible identification of white matter tracts across subjects is essential for the study of structural connectivity of the human brain. The key challenges are anatomical differences between subjects and human rater subjectivity in labeling. Labeling white matter regions of interest presents many challenges due to the need to integrate both local and global information. Clearly communicating the human/manual processes to capture this information is cumbersome, yet essential to lay a solid foundation for comprehensive atlases. The state-of-the-art for white matter atlas is the single population-averaged Johns Hopkins Eve atlas. A critical bottleneck with the Eve atlas framework is that manual labeling time is extensive and peripheral white matter regions are conservatively labeled. In this work, we developed protocols that will facilitate manual virtual dissection of white matter pathways, with the goals to be anatomically accurate, intuitive, reproducible, and act as an initial stage to build an amenable knowledge base of neuroanatomical regions. We analyzed reproducibility of the fiber bundles and variability of human raters using DICE correlation coefficient, intraclass correlation coefficient, and root mean squared error. The protocols at their initial stage have shown promising results on both typical 3T research acquisition Baltimore Longitudinal Study of Aging and high-acquisition quality Human Connectome Project datasets. The TractEM manual labeling protocols allow for reconstruction of reproducible subject-specific fiber bundles across the brain. The protocols and sample results have been made available in open source to improve generalizability and reliability in collaboration.