FiberGeoText: A Vision-Language Model for Population- Level Organization of Superficial White Matter

Vision language models have transformed 2D medical imaging, yet extending them to 3D white matter tractography remains challenging due to the complex topology of fiber bundles. We introduce TractoGraphVLM, a unified framework for four tasks, bundle classification, text-to-tract retrieval, anatomical captioning, and visual question answering, built on a shared GPS architecture, training procedure, and read-out design. Fiber bundles are represented as streamline graphs whose nodes encode 3D position and tangent orientation. A General, Powerful, Scalable (GPS) graph transformer produces bundle embeddings aligned with a frozen BiomedBERT text encoder via contrastive learning, while a BioGPT decoder with visual prefix tokens generates captions and answers. A single shared encoder and decoder is trained jointly across all four tasks and evaluated from one checkpoint. Trained on HCP Young Adult subjects, TractoGraphVLM achieves 91.8% bundle classification accuracy, 84.7% retrieval R@1, BLEU-4=20.1, ROUGE-L=66.8, and 66.4% VQA accuracy on a held-out test set. The same checkpoints transfer zero-shot to HCP Aging subjects, with a modest drop on discriminative tasks and a larger drop on generative tasks, showing robustness to age and acquisition shift. Language supervision yields richer representations than label-only training, recovering structure like hemisphere and fiber family, carried by captions but never given as a label. Swapping only the visual encoder, graphs preserving fiber orientation outperform volumetric baselines, with GPS giving the best balance. Generative metrics measure consistency with a structured knowledge base rather than independent clinical text; even so, TractoGraphVLM shows that classifying, retrieving, describing, and answering questions about a white matter bundle can be served by one jointly trained model that learns transferable neuroanatomy from language alone.

Diffusion MRI tractography enables in vivo reconstruction of white matter (WM) pathways. Two key tasks in tractography analysis include: 1) tractogram registration that aligns streamlines across individuals, and 2) streamline clustering that groups streamlines into compact fiber bundles. Although both tasks share the goal of capturing geometrically similar structures to characterize consistent WM organization, they are typically performed independently. In this work, we propose TractoRC, a unified probabilistic framework that jointly performs tractogram registration and streamline clustering within a single optimization scheme, enabling the two tasks to leverage complementary information. TractoRC learns a latent embedding space for streamline points, which serves as a shared representation for both tasks. Within this space, both tasks are formulated as probabilistic inference over structural representations: registration learns the distribution of anatomical landmarks as probabilistic keypoints to align tractograms across subjects, and clustering learns streamline structural prototypes that capture geometric similarity to form coherent streamline clusters. To support effective learning of this shared space, we introduce a transformation-equivariant self-supervised strategy to learn geometry-aware and transformation-invariant embeddings. Experiments demonstrate that jointly optimizing registration and clustering significantly improves performance in both tasks over state-of-the-art methods that treat them independently. Code will be made publicly available at https://github.com/yishengpoxiao/TractoRC .

Diffusion MRI (dMRI) tractography is the only noninvasive approach for mapping white-matter pathways in the living human brain. It represents each brain as a tractogram: a large, unordered set of three-dimensional streamlines that includes information about both local streamline geometry and whole-brain anatomical organization. This structure makes tractograms a natural but challenging target for representation learning. Existing methods treat streamline classification and subject-level prediction as separate problems: streamline classifiers focus on geometric patterns, whereas subject-level prediction often depends on hand-crafted features. As a result, current methods do not learn reusable representations that connect streamline anatomy with whole-brain inter-subject variation. Here we introduce TractFM, a tractogram foundation model that learns reusable representations directly from whole-brain streamline sets. TractFM combines a local streamline encoder with a permutation-equivariant tractogram encoder, allowing all streamlines from a subject to be contextualized jointly in a single forward pass. Pretraining on dense anatomical tract parcellation, i.e., assigning anatomical labels to individual streamlines, yields two complementary representations: contextualized streamline-level embeddings for tract parcellation and compact subject-level descriptors for downstream prediction of subject phenotypes. Across three tractography algorithms and five dMRI datasets, TractFM transfers to both streamline-level and subject-level tasks. Its frozen representations achieve accurate tract parcellation and predict age and sex across independent datasets. These results show that whole-brain geometric context, learned once, can generalize across tractography pipelines, datasets, and prediction tasks.