Due to difference in anatomical definitions, population variability and tractography methods, it will not be possible to standardize brain tractography for users, or will it?

Standardization of diffusion MRI tractography remains a major challenge due to variability in anatomical definitions, subject-specific white matter organization, pathology, acquisition protocols, and tractography methods. This short communication summarizes the key points of a debate on the limitations and opportunities in standardizing tractography across basic research and clinical settings held at the 2024 Tract-Anat Retreat. While full harmonization may be infeasible, there is optimism given the high performance of many current tractography methods, their demonstrated utility in multiple applications, and flexibility for adapting to the previously mentioned variabilities. Ultimately, what will be best will depend on the brain region and application, thereby reflecting the need for multiple dedicated standardized protocols.