Overcoming challenges of the human spinal cord tractography for routine clinical use: a review

Corentin Dauleac, Carole Frindel, Patrick Mertens, Timothée Jacquesson, François Cotton

Research output: Contribution to journalReview articlepeer-review

9 Citations (Scopus)


The spinal cord (SC) is a dense network of billions of fibers in a small volume surrounded by bones that makes tractography difficult to perform. We aim to provide a review collecting all technical settings of SC tractography and propose the optimal set of parameters to perform a good SC tractography rendering. The MEDLINE database was searched for articles reporting “spinal cord” “tractography” in “humans”. Studies were selected only when tractography rendering was displayed and MRI acquisition and tracking parameters detailed. From each study, clinical context, imaging acquisition settings, fiber tracking parameters, region of interest (ROI) design, and quality of the tractography rendering were extracted. Quality of tractography rendering was evaluated by several objective criteria proposed herein. According to the reported studies, to obtain a good tractography rendering, diffusion tensor imaging acquisition should be performed with 1.5 or 3 Tesla MRI, in the axial plane, with > 20 directions; b value: 1000 s mm−2; right-left phase-encoding direction for cervical SC; isotropic voxel size; and no slice gap. Concerning the tracking process, it should be performed with determinist approach, fractional anisotropy threshold between 0.15 and 0.2, and curvature threshold of 40°. ROI design is an essential step for providing good tractography rendering, and their placement has to consider partial volume effects, magnetic susceptibility effects, and motion artifacts. The review reported herein highlights that successful SC tractography depends on many factors (imaging acquisition settings, fiber tracking parameters, and ROI design) to obtain a good SC tractography rendering.

Original languageEnglish
Pages (from-to)1079-1094
Number of pages16
Issue number9
Publication statusPublished - 2020 Sept 1


  • Diffusion tensor imaging
  • Fiber tracking
  • Review
  • Spinal cord
  • Tractography


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