The point here is cooldown and protections to proc heal and regrowth as much as possible, the optional items are just as viable as main path, just depends of opposing team's lineup (heavy mag/burst, oni garb or magical spectral is definitely better etc.)
Swaps (3)
In the case you want more late game sustain, higher prots, run first, although regrowth makes you almost unkillable in solo 1s.
Use when high crit damage, physical or magical spectral dependent on comp of enemy team