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Thomas TOURDIAS




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Cursus:
MD: Radiology, Bordeaux (2008)
PhD: Neurosciences, Bordeaux (2011)
Post doc: Stanford University, CA, USA (2013)
Professeur des Universités - Praticien Hospitalier; PU PH (2016)






81 publication(s) since Décembre 2006:


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The indicated IF have been collected by the Web of Sciences in


12/06/2014 | j Neuroradiol   IF 3.4
Exceptional symmetric anterior brainstem involvement in leptomeningeal carcinomatosis.
Crombe A, Alberti N, Durieux M, Frulio N, Dousset V, Tourdias T

Abstract:





29/05/2014 | Magn Reson Med   IF 3.6
Optimization of white-matter-nulled magnetization prepared rapid gradient echo (MP-RAGE) imaging.
Saranathan M, Tourdias T, Bayram E, Ghanouni P, Rutt BK

Abstract:
PURPOSE: To optimize the white-matter-nulled (WMn) Magnetization Prepared Rapid Gradient Echo (MP-RAGE) sequence at 7 Tesla (T), with comparisons to 3T. METHODS: Optimal parameters for maximizing signal-to-noise ratio (SNR) efficiency were derived. The effect of flip angle and repetition time (TR) on image blurring was modeled using simulations and validated in vivo. A novel two-dimensional (2D) -centric radial fan beam (RFB) k-space segmentation scheme was used to shorten scan times and improve parallel imaging. Healthy subjects as well as patients with multiple sclerosis and tremor were scanned using the optimized protocols. RESULTS: Inversion repetition times (TS) of 4.5 s and 6 s were found to yield the highest SNR efficiency for WMn MP-RAGE at 3T and 7T, respectively. Blurring was more sensitive to flip in WMn than in CSFn MP-RAGE and relatively insensitive to TR for both regimes. The 2D RFB scheme had 19% and 47% higher thalamic SNR and SNR efficiency than the 1D centric scheme for WMn MP-RAGE. Compared with 3T, SNR and SNR efficiency were higher for the 7T WMn regime by 56% and 41%, respectively. MS lesions in the cortex and thalamus as well as thalamic subnuclei in tremor patients were clearly delineated using WMn MP-RAGE. CONCLUSION: Optimization and new view ordering enabled MP-RAGE imaging with 0.8-1 mm3 isotropic spatial resolution in scan times of 5 min with whole brain coverage. Magn Reson Med, 2014. (c) 2014 Wiley Periodicals, Inc.




05/2014 | Invest Radiol   IF 5.2
Optimization of magnetization-prepared 3-dimensional fluid attenuated inversion recovery imaging for lesion detection at 7 T.
Saranathan M, Tourdias T, Kerr AB, Bernstein JD, Kerchner GA, Han MH, Rutt BK

Abstract:
PURPOSE: The aim of this study was to optimize the 3-dimensional (3D) fluid attenuated inversion recovery (FLAIR) pulse sequence for isotropic high-spatial-resolution imaging of white matter (WM) and cortical lesions at 7 T. MATERIALS AND METHODS: We added a magnetization-prepared (MP) FLAIR module to a Cube 3D fast spin echo sequence and optimized the refocusing flip angle train using extended phase graph simulations, taking into account image contrast, specific absorption rate (SAR), and signal-to-noise ratio (SNR) as well as T1/T2 values of the different species of interest (WM, grey matter, lesions) at 7 T. We also effected improved preparation homogeneity at 7 T by redesigning the refocusing pulse used in the MP segments. Two sets of refocusing flip angle trains-(a) an SNR-optimal and (b) a contrast-optimal set-were derived and used to scan 7 patients with Alzheimer disease/cognitive impairment and 7 patients with multiple sclerosis. Conventional constant refocusing flip MP-FLAIR images were also acquired for comparison. Lesion SNR, contrast, and lesion count were compared between the 2 optimized and the standard FLAIR sequences. RESULTS: Whole brain coverage with 0.8 mm isotropic spatial resolution in approximately 5-minute scan times was achieved using the optimized 3D FLAIR sequences at clinically acceptable SAR levels. The SNR efficiency of the SNR-optimal sequence was significantly better than that of conventional constant refocusing flip MP-FLAIR sequence, whereas the scan time was reduced more than 2-fold ( approximately 5 vs >10 minutes). The contrast efficiency of the contrast-optimal sequence was comparable with that of the constant refocusing flip sequence. Lesion load ascertained by lesion counting was not significantly different among the sequences. CONCLUSION: Magnetization-prepared FLAIR-Cube with refocusing flip angle trains optimized for SNR and contrast can be used to characterize WM and cortical lesions at 7 T with 0.8 mm isotropic resolution in short scan times and without SAR penalty.




07/09/2013 | Neuroimage   IF 5.9
Visualization of intra-thalamic nuclei with optimized white-matter-nulled MPRAGE at 7T.
Tourdias T, Saranathan M , Levesque IR , Su J , Rutt BK

Abstract:
Novel MR image acquisition strategies have been investigated to elicit contrast within the thalamus, but direct visualization of individual thalamic nuclei remains a challenge because of their small size and the low intrinsic contrast between adjacent nuclei. We present a step-by-step specific optimization of the 3D MPRAGE pulse sequence at 7T to visualize the intra-thalamic nuclei. We first measured T1 values within different sub-regions of the thalamus at 7T in 5 individuals. We used these to perform simulations and sequential experimental measurements (n=17) to tune the parameters of the MPRAGE sequence. The optimal set of parameters was used to collect high-quality data in 6 additional volunteers. Delineation of thalamic nuclei was performed twice by one rater and MR-defined nuclei were compared to the classic Morel histological atlas. T1 values within the thalamus ranged from 1400ms to 1800ms for adjacent nuclei. Using these values for theoretical evaluations combined with in vivo measurements, we showed that a short inversion time (TI) close to the white matter null regime (TI=670ms) enhanced the contrast between the thalamus and the surrounding tissues, and best revealed intra-thalamic contrast. At this particular nulling regime, lengthening the time between successive inversion pulses (TS=6000ms) increased the thalamic signal and contrast and lengthening the alpha pulse train time (N*TR) further increased the thalamic signal. Finally, a low flip angle during the gradient echo acquisition (alpha=4 degrees ) was observed to mitigate the blur induced by the evolution of the magnetization along the alpha pulse train. This optimized set of parameters enabled the 3D delineation of 15 substructures in all 6 individuals; these substructures corresponded well with the known anatomical structures of the thalamus based on the classic Morel atlas. The mean Euclidean distance between the centers of mass of MR- and Morel atlas-defined nuclei was 2.67mm (+/-1.02mm). The reproducibility of the MR-defined nuclei was excellent with intraclass correlation coefficient measured at 0.997 and a mean Euclidean distance between corresponding centers of mass found at first versus second readings of 0.69mm (+/-0.38mm). This 7T strategy paves the way to better identification of thalamic nuclei for neurosurgical planning and investigation of regional changes in neurological disorders.




04/2013 | AJR Am J Roentgenol   IF 3
Combined late gadolinium-enhanced and double-echo chemical-shift MRI help to differentiate renal oncocytomas with high central T2 signal intensity from renal cell carcinomas.
Cornelis F , Lasserre AS , Tourdias T , Deminiere C , Ferriere JM , Le Bras Y , Grenier N

Abstract:
OBJECTIVE: The purpose of our study was to evaluate the combination of dynamic contrast-enhanced T1-weighted and double-echo gradient-echo MR imaging to distinguish renal oncocytoma with high T2 signal intensity centrally from renal cell carcinoma (RCC). MATERIALS AND METHODS: Between 2006 and 2011, 63 renal tumors (59 patients) presenting with a high signal intensity (SI) central area on T2-weighted sequences were imaged with dynamic contrast-enhanced sequences, including phases later than 5 minutes after contrast injection, and double-echo chemical-shift sequences were selected from our institutional database. Two experienced radiologists visually assessed presence and distribution of signal enhancement of central areas after injection and measured SI changes on opposed-phase images for calculation of the SI index and tumor-to-spleen ratio. Cutoff values were derived from the receiver operating characteristic (ROC) curve. RESULTS: There were 19 oncocytomas (16 patients), 43 RCCs (42 patients), and one leiomyoma. Complete late enhancement of the central area was observed in 14 oncocytomas (74%) and in five RCCs (12%) (p = 0.05). The combination of complete enhancement and SI index lower than 2% (p = 0.02) or tumor-to-spleen ratio higher than -6% (p = 0.001) provided sensitivity of 36% and 55%, specificity of 95% and 97%, positive predictive value of 67% and 86%, and negative predictive value of 84% and 88%, respectively, for diagnosis of oncocytomas. CONCLUSION: Absence of central area SI inversion or presence of a signal drop on chemical-shift imaging may rule out the diagnosis of oncocytoma.




01/2013 | Neurotherapeutics   IF 6
Neuroinflammatory imaging biomarkers: relevance to multiple sclerosis and its therapy.
Tourdias T , Dousset V

Abstract:
Magnetic resonance imaging is an established tool in the management of multiple sclerosis (MS). Loss of blood brain barrier integrity assessed by gadolinium (Gd) enhancement is the current standard marker of MS activity. To explore the complex cascade of the inflammatory events, other magnetic resonance imaging, but also positron emission tomographic markers reviewed in this article are being developed to address active neuroinflammation with increased sensitivity and specificity. Alternative magnetic resonance contrast agents, positron emission tomographic tracers and imaging techniques could be more sensitive than Gd to early blood brain barrier alteration, and they could assess the inflammatory cell recruitment and/or the associated edema accumulation. These markers of active neuroinflammation, although some of them are limited to experimental studies, could find great relevance to complete Gd information and thereby increase our understanding of acute lesion pathophysiology and its noninvasive follow-up, especially to monitor treatment efficacy. Furthermore, such accurate markers of inflammation combined with those of neurodegeneration hold promise to provide a more complete picture of MS, which will be of great benefit for future therapeutic strategies.




01/2013 | J Cereb Blood Flow Metab   IF 5.7
Quantitative measurements of relative fluid-attenuated inversion recovery (FLAIR) signal intensities in acute stroke for the prediction of time from symptom onset.
Cheng B , Brinkmann M , Forkert ND , Treszl A , Ebinger M , Kohrmann M , Wu O , Kang DW , Liebeskind DS , Tourdias T , Singer OC , Christensen S , Luby M , Warach S , Fiehler J , Fiebach JB , Gerloff C , Thomalla G

Abstract:
In acute stroke magnetic resonance imaging, a 'mismatch' between visibility of an ischemic lesion on diffusion-weighted imaging (DWI) and missing corresponding parenchymal hyperintensities on fluid-attenuated inversion recovery (FLAIR) data sets was shown to identify patients with time from symptom onset



12/2012 | Anesthesiology   IF 7.1
Assessment of white matter injury and outcome in severe brain trauma: a prospective multicenter cohort.
Galanaud D , Perlbarg V , Gupta R , Stevens RD , Sanchez P , Tollard E , de Champfleur NM , Dinkel J , Faivre S , Soto-Ares G , Veber B , Cottenceau V , Masson F , Tourdias T , Andre E , Audibert G , Schmitt E , Ibarrola D , Dailler F , Vanhaudenhuyse A , Tshibanda L , Payen JF , Le Bas JF , Krainik A , Bruder N , Girard N , Laureys S , Benali H , Puybasset L

Abstract:
BACKGROUND: Existing methods to predict recovery after severe traumatic brain injury lack accuracy. The aim of this study is to determine the prognostic value of quantitative diffusion tensor imaging (DTI). METHODS: In a multicenter study, the authors prospectively enrolled 105 patients who remained comatose at least 7 days after traumatic brain injury. Patients underwent brain magnetic resonance imaging, including DTI in 20 preselected white matter tracts. Patients were evaluated at 1 yr with a modified Glasgow Outcome Scale. A composite DTI score was constructed for outcome prognostication on this training database and then validated on an independent database (n=38). DTI score was compared with the International Mission for Prognosis and Analysis of Clinical Trials Score. RESULTS: Using the DTI score for prediction of unfavorable outcome on the training database, the area under the receiver operating characteristic curve was 0.84 (95% CI: 0.75-0.91). The DTI score had a sensitivity of 64% and a specificity of 95% for the prediction of unfavorable outcome. On the validation-independent database, the area under the receiver operating characteristic curve was 0.80 (95% CI: 0.54-0.94). On the training database, reclassification methods showed significant improvement of classification accuracy (P < 0.05) compared with the International Mission for Prognosis and Analysis of Clinical Trials score. Similar results were observed on the validation database. CONCLUSIONS: White matter assessment with quantitative DTI increases the accuracy of long-term outcome prediction compared with the available clinical/radiographic prognostic score.




11/2012 | Stroke   IF 7.2
Hyperintense vessels on acute stroke fluid-attenuated inversion recovery imaging: associations with clinical and other MRI findings.
Cheng B , Ebinger M , Kufner A , Kohrmann M , Wu O , Kang DW , Liebeskind D , Tourdias T , Singer OC , Christensen S , Warach S , Luby M , Fiebach JB , Fiehler J , Gerloff C , Thomalla G

Abstract:
BACKGROUND AND PURPOSE: Hyperintense vessels (HVs) have been observed in fluid-attenuated inversion recovery imaging of patients with acute ischemic stroke and been linked to slow flow in collateral arterial circulation. Given the potential importance of HV, we used a large, multicenter data set of patients with stroke to clarify which clinical and imaging factors play a role in HV. METHODS: We analyzed data of 516 patients from the previously published PRE-FLAIR study (PREdictive value of FLAIR and DWI for the identification of acute ischemic stroke patients



11/2012 | Radiology   IF 7.9
Prediction of subacute infarct size in acute middle cerebral artery stroke: comparison of perfusion-weighted imaging and apparent diffusion coefficient maps.
Drier A, Tourdias T , Attal Y , Sibon I , Mutlu G , Lehericy S , Samson Y , Chiras J , Dormont D , Orgogozo JM , Dousset V , Rosso C

Abstract:
PURPOSE: To compare perfusion-weighted (PW) imaging and apparent diffusion coefficient (ADC) maps in prediction of infarct size and growth in patients with acute middle cerebral artery infarct. MATERIALS AND METHODS: This study was approved by the local institutional review board. Written informed consent was obtained from all 80 patients. Subsequent infarct volume and growth on follow-up magnetic resonance (MR) images obtained within 6 days were compared with the predictions based on PW images by using a time-to-peak threshold greater than 4 seconds and ADC maps obtained less than 12 hours after middle cerebral artery infarct. ADC- and PW imaging-predicted infarct growth areas and infarct volumes were correlated with subsequent infarct growth and follow-up diffusion-weighted (DW) imaging volumes. The impact of MR imaging time delay on the correlation coefficient between the predicted and subsequent infarct volumes and individual predictions of infarct growth by using receiver operating characteristic curves were assessed. RESULTS: The infarct volume measurements were highly reproducible (concordance correlation coefficient [CCC] of 0.965 and 95% confidence interval [CI]: 0.949, 0.976 for acute DW imaging; CCC of 0.995 and 95% CI: 0.993, 0.997 for subacute DW imaging). The subsequent infarct volume correlated (P<.0001) with ADC- (rho=0.853) and PW imaging- (rho=0.669) predicted volumes. The correlation was higher for ADC-predicted volume than for PW imaging-predicted volume (P<.005), but not when the analysis was restricted to patients without recanalization (P=.07). The infarct growth correlated (P<.0001) with PW imaging-DW imaging mismatch (rho=0.470) and ADC-DW imaging mismatch (rho=0.438), without significant differences between both methods (P=.71). The correlations were similar among time delays with ADC-predicted volumes but decreased with PW imaging-based volumes beyond the therapeutic window. Accuracies of ADC- and PW imaging-based predictions of infarct growth in an individual prediction were similar (area under the receiver operating characteristic curve [AUC] of 0.698 and 95% CI: 0.585, 0.796 vs AUC of 0.749 and 95% CI: 0.640, 0.839; P=.48). CONCLUSION: The ADC-based method was as accurate as the PW imaging-based method for evaluating infarct growth and size in the subacute phase.