Diffusion tensor imaging and beyond.

The diffusion of water molecules inside organic tissues is often anisotropic (1). Namely, if there are aligned structures in the tissue, the apparent diffusion coefficient (ADC) of water may vary depending on the orientation along which the diffusion-weighted (DW) measurements are taken. In the late 1980s, diffusion-weighted imaging (DWI) became possible by combining MR diffusion measurements with imaging, enabling the mapping of both diffusion constants and diffusion anisotropy inside the brain and revealing valuable information about axonal architectures (2–14). In the beginning of the 1990s, the diffusion tensor model was introduced to describe the degree of anisotropy and the structural orientation information quantitatively (15,16). This diffusion tensor imaging (DTI) approach provided a simple and elegant way to model this complex neuroanatomical information using only six parameters. Since then, we have witnessed a tremendous amount of growth in this research field, including more sophisticated nontensor models to describe diffusion properties and to extract finer anatomical information from each voxel. Three-dimensional (3D) reconstruction technologies for white matter tracts are also developing beyond the initial deterministic line-propagation models (17–20). As these new reconstruction methods are an area of very active research, it is important to remember that the theory cannot be dissociated from practical aspects of the technology. Importantly, DWI is inherently a noisesensitive and artifact-prone technique (Fig. 1). Thus, we cannot overemphasize the importance of image quality assurance and robust image analysis techniques. Last but not least, data acquisition technologies have also been steadfastly evolving. In this article, we review the recent advances in these areas since 2000.