Dr. James Thrall

PACS/VNA
MGH's Thrall reflects on 30 years in radiology
On February 1, Dr. James Thrall stepped down as chairman of the department of radiology at Massachusetts General Hospital (MGH), ending a 30-year career as one of the leading figures in radiology. In this exclusive article, Dr. Thrall reflects on the changes he's seen over the past 30 years in medical imaging.
February 25, 2013
2013 02 25 11 30 07 718 Thrall James 70
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Representative cardiac MRI strain images and analysis. Images in the two-, four-, and three-chamber views for strain analysis (left) and left ventricular global longitudinal strain (GLS) and global early diastolic longitudinal strain rate (eGLSR) curves (right) are shown. (A) Example images and GLS and eGLSR curves in a 37-year-old male participant with diabetes mellitus (DM) without events during follow-up after cardiac MRI. (B) Example images and GLS and eGLSR curves in a 45-year-old male participant with DM who had heart failure hospitalization during follow-up after cardiac MRI. In the left images, blue represents higher myocardial strain (higher absolute values of negative strain), whereas red represents reduced strain. In the curves, blue represents GLS, whereas orange represents eGLSR. The left y-axis denotes GLS (%), the right y-axis represents eGLSR (per second), and the x-axis denotes time (milliseconds). For these strain parameters, a lower absolute value indicates more severe myocardial functional impairment; accordingly, GLS and eGLSR were more impaired in participants with events compared with those without events.
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Bar graphs show comparison of volume CT dose index (CTDIvol) (A) achievable doses (50th percentile) and (B) diagnostic reference levels (75th percentile) between 2014 (see reference 4 by Kanal et al) and 2025 (present study) for 10 common CT examination types performed without contrast (w/o) and with contrast (w/). Across all 10 adult CT examination categories, CTDIvol achievable doses and diagnostic reference levels generally decreased from 2014 to 2025, with the largest reductions for torso examinations (chest; abdomen-pelvis; and combined chest, abdomen, and pelvis), intermediate reductions for neck and cervical spine, and minimal change for head examinations.
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Images in a 70-year-old asymptomatic woman with a prior excisional biopsy in the left breast yielding lobular carcinoma in situ 3 years earlier. Screening contrast-enhanced mammography (CEM) was performed, which was considered a prevalence screen as the woman had no prior breast MRI in the past 3 years and no prior CEM. (A) Low-energy (26–30 kVp) mediolateral oblique (MLO) and (B) craniocaudal (CC) views show surgical clips but no abnormality. (C) Recombined MLO and (D) CC images show an enhancing mass in the medial left breast (arrows). Biopsy revealed invasive lobular carcinoma. Size was 0.2 cm; tumor grade II/III; negative lymph nodes; and estrogen receptor–positive, progesterone receptor–positive, and human epidermal growth factor receptor 2–negative.
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Representative cardiac MRI strain images and analysis. Images in the two-, four-, and three-chamber views for strain analysis (left) and left ventricular global longitudinal strain (GLS) and global early diastolic longitudinal strain rate (eGLSR) curves (right) are shown. (A) Example images and GLS and eGLSR curves in a 37-year-old male participant with diabetes mellitus (DM) without events during follow-up after cardiac MRI. (B) Example images and GLS and eGLSR curves in a 45-year-old male participant with DM who had heart failure hospitalization during follow-up after cardiac MRI. In the left images, blue represents higher myocardial strain (higher absolute values of negative strain), whereas red represents reduced strain. In the curves, blue represents GLS, whereas orange represents eGLSR. The left y-axis denotes GLS (%), the right y-axis represents eGLSR (per second), and the x-axis denotes time (milliseconds). For these strain parameters, a lower absolute value indicates more severe myocardial functional impairment; accordingly, GLS and eGLSR were more impaired in participants with events compared with those without events.
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