White matter tractography is an advanced neuroimaging technique that reconstructs the 3D white matter pathways of the brain from diffusion MRI data. It can be framed as a pathfinding problem aiming to infer neural fiber trajectories from noisy and ambiguous measurements, facing challenges such as crossing, merging, and fanning white-matter configurations. In this paper, we propose a novel tractography method that leverages Transformers to model the sequential nature of white matter streamlines, enabling the prediction of fiber directions by integrating both the trajectory context and current diffusion MRI measurements. To incorporate spatial information, we utilize CNNs that extract microstructural features from local neighborhoods around each voxel. By combining these complementary sources of information, our approach improves the precision and completeness of neural pathway mapping compared to traditional tractography models. We evaluate our method with the Tractometer toolkit, achieving competitive performance against state-of-the-art approaches, and present qualitative results on the TractoInferno dataset, demonstrating strong generalization to real-world data.

Reinforcement learning (RL)-based tractography is a competitive alternative to machine learning and classical tractography algorithms due to its high anatomical accuracy obtained without the need for any annotated data. However, the reward functions so far used to train RL agents do not encapsulate anatomical knowledge which causes agents to generate spurious false positives tracts. In this paper, we propose a new RL tractography system, TractOracle, which relies on a reward network trained for streamline classification. This network is used both as a reward function during training as well as a mean for stopping the tracking process early and thus reduce the number of false positive streamlines. This makes our system a unique method that evaluates and reconstructs WM streamlines at the same time. We report an improvement of true positive ratios by almost 20\% and a reduction of 3x of false positive ratios on one dataset and an increase between 2x and 7x in the number true positive streamlines on another dataset.