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Dedouit Fabrice

Dédouit Fabrice , HDR, M.D., Ph.D.
Head of the Unit of Forensic and Anthropological Imaging at the University Center of Legal Medicine (CURLM) Lausanne-Geneva
Radiologist, Forensic pathologist
Gold medal of the medicine theses of the Medicine Faculty of TOULOUSE
Member of the national executive council of the French Society of Radiology.
President of the French Working Group Forensic Imaging (GRAVIT=Groupe de Recherche en Autopsie Virtuelle et Imagerie Thanatologique).
Contact : fabrice.dedouit(a)chuv.ch
Tel : + 00 41 79 556 85 89

Research interests :
Post mortem imaging

1. Post mortem Multi Slice Computed Tomography and Post mortem angio CT scan
2. Post mortem MRI and Spectro-MRI
3. 3D surface scanner
Anthropological imaging
1. Bone and teeth interests :
a. Lesion identification
b. Comparative reconstruction
c. Reconstructive reconstruction
2. Geometric morphometric methods

Current research projects :
Post mortem imaging
Since 10 years, the progresses performed with post mortem radiology are important. It is clearly worldwide admitted that complementary explorations surrounding medico-legal autopsies are useful and necessary. The post mortem imaging is one of those explorations.
The introduction of modern slice imaging features like multislice computed tomography (MSCT) and Magnetic Resonance Imaging (MRI) have modified the forensic practice of autopsies.

1. Post mortem MSCT and Post mortem angio CT scan
The work done with post-mortem angio CT scans is major for adults. This technique necessitates a specific material in terms of contrast media and injection machine. It allows a post mortem filling of the vessels and consequently brings informations concerning the vascular state of a deceased (stenosis, leakage, rupture, thrombus etc.). However, like in pathology or in clinic, the constitution of large samples or series is crucial. The constitution of series is time consuming. The department of forensic imaging of the CURLM has already an important number of radiological post mortem explorations that will increase in the coming 5-10 years. This will permit to focus the interest of a study on some particular situations : for example motor vehicle accidents, falls from great heights etc.
The study of natural deaths can also be completely modified through post mortem imaging. The description of the precise semeiology for example concerning myocardial infarctions is a high challenge. Further studies in this domain are necessary.
In the world, a lot of sudden deaths in adult populations are not autopsied and are studied only with an external examination. The definition and establishment of radiological criteria and of a post mortem radiological semeiology could permit to precisely determine the cause of death : cerebral stroke, myocardial infarction, pulmonary embolisms etc. It is clear that a correct radiological exploration (with or without contrast media injection) will always be better than no internal exploration in terms of informations allowing the determination of the cause of death.
Concerning the post mortem angio CT scan for adults, further works need to be done and evaluate. Some specific forensic situations need to be tested, evaluated and improved concerning for example selective opacifications of the upper or lower members.
An important work has to be performed concerning the development of specific protocols for children and neonates. This is of high importance for cases of sudden death infant syndrome (SDIS). The development of angiographic protocols could also permit to detect malformations (vascular, cardiac, etc.) that can lead to death.

2. Post mortem MRI and Spectro-MRI
The fact of having our own MRI for a post mortem use is a major step for research projects. Through the world, the contribution of this tool in post mortem imaging is clearly weak compared to MSCT. Of course, this is not due to the fact that it is a bad tool (because is it surely the best one), but explained by difficulties of availability of the clinical machines. In Lausanne, we will have our own material, with the possibilities of development and testing new protocols.
The utilisation the spectro-MRI opens also different possibilities. This complementary tool which is an MRI with a complementary tool of spectroscopy adds complementary informations. At this moment those techniques have been used only to estimate time interval of death. This could also be used for example for toxicology analyses. Indeed, a lot of autopsies, with no macroscopical diagnose concerning the determination of the cause of death are secondary to drug abuse. It may concern medical drugs, drugs but also alcohol. Of course this development will be done in collaboration with the toxicological department of the CURLM.

3. 3D surface scanner
The 3D surface scanners permit to create photo-realistic, 3 dimensional images of complex environments and objects.
In the forensic literature, the surface scanners are published most of time as case reports. This tool is available in the CURLM and will give us the possibility to constitute large series of forensic cases. With the help of the specialized personnel dedicated to this activity in the CURLM, it could be the opportunity to integrate this tool in a routine process. There are also possibilities of fusions of images coming from MSCT explorations and 3D surface scanners.

Anthropological imaging
1. Bone and teeth interests
In physical anthropology, most of the classical methods are based on osteological analyses. The constitution of a virtual bone collection presents a lot of advantages : in terms of quality and quantity, the bones and teeth’ accesses are largely increased compared to real bone collections.
The great advantages of the images are their easy and great possibilities of transfer compared to bones.
The first step of development of radiological applications in anthropology, which is quite developed, is transposition of pre-exisiting ‘historical’ or classical methods from osteological to radiological state. It permits to test this transposition, to adapt some criteria, and increase the accuracy of the method. It allows also study of a larger population in terms of number.
The second step is the description of original criteria that can be used in reconstructive identification. The reconstructive identification is based on the determination or assessment of age-at-death, sex, stature and also geographical origin.

2. Geometric morphometric methods
Geometric morphometrics permits the quantitative representation and analysis of morphological shape using geometric coordinates instead of measurements. The major goal of geometric morphometrics is measuring morphological similarities and differences. Results can be presented visually as a “shape” than tables of numbers. Data can be collected from digital photographs or MSCT images. For anthropological purpose, the great interest is the differentiation possible between size and shape. This is of high interest when the dimorphism is studied, allowing the characterize differences between males and females in terms of size but also shape. In geometric morphometrics the size is mathematically removed from the analysis to focus on pure shape.

Research experience
- MSc (second level) in Biological Anthropology, 2004, University Paul Sabatier of Toulouse, France
- Ph.D. Thesis in Biological Anthropology, Imagerie en coupe et anthropologie : applications médico-légales pour la détermination de l’âge, 2009, University Paul Sabatier of Toulouse, France
- Habilitation (“accreditation to supervise research”) Equivalent to Privat-docent, Theme : Virtual anthropology, 2011, University Paul Sabatier of Toulouse, France
- Docent in the University Hospital of Toulouse, forensic department, France, (second class) September 2011 – September 2014
- Docent in the University Hospital of Toulouse, forensic department, France, (first class) September 2014 –December 2015
- Head of the unit of Forensic and Anthropological Imaging at the University Center of Legal Medicine (CURLM) Lausanne-Geneva, Since January 2016

Bibliography
Last papers
Diagnostic value of high-resolution peripheral quantitative computed tomography (HR-pQCT) in the qualitative assessment of Cribra Orbitalia – a preliminary study. Saint-Martin P, Dedouit F, Rérolle C, Guilbeau-Frugier C, Dabernat H, Rougé D, Telmon N, Crubézy E. Journal of Comparative Human Biology HOMO, 2015 ; 66 (1) : 38-43.

Pitfalls in post-mortem CT-angiography – intravascular contrast induces postmortem pericardial effusion. Grabherr S, Wittig H, Dedouit F, Wozniak K, Vogel H, Heinemann A, Fischer F, Moskala A, Guglielmi G, Mangin P, Grimm J. Legal Medicine, 2015 ; 17 (3) : 218-219.

Contribution of distal femur MRI to the determination of the 18-year limit in forensic age estimation. Saint-Martin P, Rérolle C, Pucheux J, Dedouit F, Telmon N. International Journal of Legal Medicine, 2015 ; 129 (3) : 619-620.

Mejdoubi M, Dedouit F, Mokrane FZ, Telmon N. Semicircular canal angulation during fetal life : a computed tomography study of 54 human fetuses. Otology & Neurotology, 2015 ; 36 (4) : 701-704.

Is the persistence of an epiphyseal scar of the knee a reliable marker of biological age ? Faisant M, Rérolle C, Faber C, Dedouit F, Telmon N, Saint-Martin P. International Journal of Legal Medicine, 2015 ; 129 (3) : 603-608.

Virtual anthropology : useful radiological tools for age assessment in clinical forensic medicine and thanatology. Dedouit F, Saint Martin P, Savall F, Mokrane F-Z, Rousseau H, Crubezy E, Rougé D, Telmon N. Radiologia Medica, 2015 ; 120 (9) : 874-886.

Ontogeny of size and shape sexual dimorphism in the pubis : a computed tomography study by geometric morphometry. Bilfeld MF, Dedouit F, Sans N, Rousseau H, Rougé D, Telmon N. Journal of Forensic Sciences, 2015 ; 60 (5) : 1121-1128.

An unusual homicidal stab wound of the cervical spinal cord : A single case examined by post-mortem computed tomography angiography (PMCTA). Savall F, Dedouit F, Mokrane FZ, Rougé D, Saint-Martin P, Telmon N. Forensic Science International, 2015 ; 254 : e18-e21.

Metric sex determination of the human coxal bone on a virtual sample using decision trees. Savall F, Faruch-Bilfeld M, Dedouit F, Sans N, Rousseau H, Rougé D, Telmon N. Journal of Forensic Sciences, 2015 ; (in press, accessible en ligne).

Contribution of magnetic resonance imaging of the wrist and hand to forensic age assessment. Serin J, Rérolle C, Pucheux J, Dedouit F, Telmon N, Savall F, Saint-Martin P. International Journal of Legal Medicine, 2016 ; (in press, accessible en ligne).

CT Scan imaging of the human fetal labyrinth : Case Series Data Throughout Gestation. Mejdoubi M, Dedouit F, Mokrane FZ, Telmon N. Otology & neurotology, 2016 ; (in press, accessible en ligne).

Chapters of books :

Radiologie thanatologique. Dedouit F, Otal Ph, Telmon N, Costagliola R, Joffre F, Rougé D. Traité de Médecine Légale. Editions De Boeck, 2008 : 119-143.

Chapter 9 : Modern Cross Sectional Imaging in Anthropology. Dedouit F, Telmon N, Rousseau H, Crubézy E, Joffre F, Rougé D. Brogdon’s Forensic Radiology. Editors : Thali MJ, Viner MD, Brogdon BG. Editions CRC Press, 2011 : 107-126.

Virtual autopsy : modern cross sectional imaging. Dedouit F, Faruch M, Telmon N, Otal P, Rousseau H, Joffre F, Rougé D. Advances in Forensic Science and Applications to Law. Editors : Sapse D, Kobilinsky L. Editions CRC Press, 2011 : 155-216.

Radiologie thanatologique. Dedouit F, Telmon N, Otal Ph, Joffre F, Costagliola R, Louryan S, Rousseau H, Rougé D. Traité de Médecine Légale. Editions De Boeck, 2011 : 135-164.

Imagerie, squelettes, os secs et anthropologie. Dedouit F, Savall F, Rousseau H, Telmon N. Manuel pratique d’anthropologie médico-légale. Editions Eska, 2014 : 429-454.

Imagerie vasculaire thanatologique en tomodensitométrie : l’angiographie tomodensitométrique multi-phases post-mortem. Dedouit F, Mokrane F-Z, Savall F, Rouge D, Telmon N, Rousseau H. Traité d’imagerie vasculaire. Editions Elsevier Masson, 2015 : 118-128.