1.Performance of Digital Mammography-Based Artificial Intelligence Computer-Aided Diagnosis on Synthetic Mammography From Digital Breast Tomosynthesis
Kyung Eun LEE ; Sung Eun SONG ; Kyu Ran CHO ; Min Sun BAE ; Bo Kyoung SEO ; Soo-Yeon KIM ; Ok Hee WOO
Korean Journal of Radiology 2025;26(3):217-229
Objective:
To test the performance of an artificial intelligence-based computer-aided diagnosis (AI-CAD) designed for fullfield digital mammography (FFDM) when applied to synthetic mammography (SM).
Materials and Methods:
We analyzed 501 women (mean age, 57 ± 11 years) who underwent preoperative mammography and breast cancer surgery. This cohort consisted of 1002 breasts, comprising 517 with cancer and 485 without. All patients underwent digital breast tomosynthesis (DBT) and FFDM during the preoperative workup. The SM is routinely reconstructed using DBT. Commercial AI-CAD (Lunit Insight MMG, version 1.1.7.2) was retrospectively applied to SM and FFDM to calculate the abnormality scores for each breast. The median abnormality scores were compared for the 517 breasts with cancer using the Wilcoxon signed-rank test. Calibration curves of abnormality scores were evaluated. The discrimination performance was analyzed using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity using a 10% preset threshold. Sensitivity and specificity were further analyzed according to the mammographic and pathological characteristics.The results of SM and FFDM were compared.
Results:
AI-CAD demonstrated a significantly lower median abnormality score (71% vs. 96%, P < 0.001) and poorer calibration performance for SM than for FFDM. SM exhibited lower sensitivity (76.2% vs. 82.8%, P < 0.001), higher specificity (95.5% vs.91.8%, P < 0.001), and comparable AUC (0.86 vs. 0.87, P = 0.127) than FFDM. SM showed lower sensitivity than FFDM in asymptomatic breasts, dense breasts, ductal carcinoma in situ, T1, N0, and hormone receptor-positive/human epidermal growth factor receptor 2-negative cancers but showed higher specificity in non-cancerous dense breasts.
Conclusion
AI-CAD showed lower abnormality scores and reduced calibration performance for SM than for FFDM.Furthermore, the 10% preset threshold resulted in different discrimination performances for the SM. Given these limitations, off-label application of the current AI-CAD to SM should be avoided.
2.Korean Registry on the Current Management of Helicobacter pylori (K-Hp-Reg): Interim Analysis of Adherence to the Revised Evidence-Based Guidelines for First-Line Treatment
Hyo-Joon YANG ; Joon Sung KIM ; Ji Yong AHN ; Ok-Jae LEE ; Gwang Ha KIM ; Chang Seok BANG ; Moo In PARK ; Jae Yong PARK ; Sun Moon KIM ; Su Jin HONG ; Joon Hyun CHO ; Shin Hee KIM ; Hyun Joo SONG ; Jin Woong CHO ; Sam Ryong JEE ; Hyun LIM ; Yong Hwan KWON ; Ju Yup LEE ; Seong Woo JEON ; Seon-Young PARK ; Younghee CHOE ; Moon Kyung JOO ; Dae-Hyun KIM ; Jae Myung PARK ; Beom Jin KIM ; Jong Yeul LEE ; Tae Hoon OH ; Jae Gyu KIM ;
Gut and Liver 2025;19(3):364-375
Background/Aims:
The Korean guidelines for Helicobacter pylori treatment were revised in 2020, however, the extent of adherence to these guidelines in clinical practice remains unclear. Herein, we initiated a prospective, nationwide, multicenter registry study in 2021 to evaluate the current management of H.pylori infection in Korea.
Methods:
This interim report describes the adherence to the revised guidelines and their impact on firstline eradication rates. Data on patient demographics, diagnoses, treatments, and eradication outcomes were collected using a web-based electronic case report form.
Results:
A total of 7,261 patients from 66 hospitals who received first-line treatment were analyzed.The modified intention-to-treat eradication rate for first-line treatment was 81.0%, with 80.4% of the prescriptions adhering to the revised guidelines. The most commonly prescribed regimen was the 14-day clarithromycin-based triple therapy (CTT; 42.0%), followed by tailored therapy (TT; 21.2%), 7-day CTT (14.1%), and 10-day concomitant therapy (CT; 10.1%). Time-trend analysis demonstrated significant increases in guideline adherence and the use of 10-day CT and TT, along with a decrease in the use of 7-day CTT (all p<0.001). Multivariate logistic regression analysis revealed that guideline adherence was significantly associated with first-line eradication success (odds ratio, 2.03; 95% confidence interval, 1.61 to 2.56; p<0.001).
Conclusions
The revised guidelines for the treatment of H. pylori infection have been increasingly adopted in routine clinical practice in Korea, which may have contributed to improved first-line eradication rates. Notably, the 14-day CTT, 10-day CT, and TT regimens are emerging as the preferred first-line treatment options among Korean physicians.
3.Performance of Digital Mammography-Based Artificial Intelligence Computer-Aided Diagnosis on Synthetic Mammography From Digital Breast Tomosynthesis
Kyung Eun LEE ; Sung Eun SONG ; Kyu Ran CHO ; Min Sun BAE ; Bo Kyoung SEO ; Soo-Yeon KIM ; Ok Hee WOO
Korean Journal of Radiology 2025;26(3):217-229
Objective:
To test the performance of an artificial intelligence-based computer-aided diagnosis (AI-CAD) designed for fullfield digital mammography (FFDM) when applied to synthetic mammography (SM).
Materials and Methods:
We analyzed 501 women (mean age, 57 ± 11 years) who underwent preoperative mammography and breast cancer surgery. This cohort consisted of 1002 breasts, comprising 517 with cancer and 485 without. All patients underwent digital breast tomosynthesis (DBT) and FFDM during the preoperative workup. The SM is routinely reconstructed using DBT. Commercial AI-CAD (Lunit Insight MMG, version 1.1.7.2) was retrospectively applied to SM and FFDM to calculate the abnormality scores for each breast. The median abnormality scores were compared for the 517 breasts with cancer using the Wilcoxon signed-rank test. Calibration curves of abnormality scores were evaluated. The discrimination performance was analyzed using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity using a 10% preset threshold. Sensitivity and specificity were further analyzed according to the mammographic and pathological characteristics.The results of SM and FFDM were compared.
Results:
AI-CAD demonstrated a significantly lower median abnormality score (71% vs. 96%, P < 0.001) and poorer calibration performance for SM than for FFDM. SM exhibited lower sensitivity (76.2% vs. 82.8%, P < 0.001), higher specificity (95.5% vs.91.8%, P < 0.001), and comparable AUC (0.86 vs. 0.87, P = 0.127) than FFDM. SM showed lower sensitivity than FFDM in asymptomatic breasts, dense breasts, ductal carcinoma in situ, T1, N0, and hormone receptor-positive/human epidermal growth factor receptor 2-negative cancers but showed higher specificity in non-cancerous dense breasts.
Conclusion
AI-CAD showed lower abnormality scores and reduced calibration performance for SM than for FFDM.Furthermore, the 10% preset threshold resulted in different discrimination performances for the SM. Given these limitations, off-label application of the current AI-CAD to SM should be avoided.
4.Age Estimation Using Attrition and Pulp Cavity Size of the Mandibular First Molar in Korean Population
Hee-Won KIM ; Hye-Mi JEON ; Kyung-Hee KIM ; Hye-Min JU ; Soo-Min OK ; Sung-Hee JEONG ; Yong-Woo AHN
Korean Journal of Legal Medicine 2025;49(1):1-6
In forensic science, age estimation is essential for identifying both living and deceased individuals. Teeth and jawbones serve as reliable indicators due to their gradual age-related changes and resistance to environmental factors. Among the various methods, attrition and pulp cavity size are commonly used to estimate adult age. This study aimed to enhance the accuracy of age estimation in Korean adults by combining measurements of tooth attrition and pulp cavity size obtained from panoramic radiographs of mandibular first molars. We evaluated 118 patients (62 male, 56 female) who visited Pusan National University Dental Hospital between 2010 and 2024. Radiographs and clinical photographs were analyzed for grade C teeth with exposed dentin using Takei’s method, and the pulp chamber height ratio (PCHR) and width ratio (PCWR) were measured using Jeon’s method. Intraobserver reliability was high (intraclass correlation coefficient>0.6), with no significant sex-based differences in PCHR and PCWR. Both ratios negatively correlated with age, with PCWR showing a stronger correlation, particularly in females (r=–0.606). This study derived an improved age estimation formula with R² values ranging from 0.540 to 0.546 when both PCHR and PCWR were combined. Despite the limitations of this study, such as its small sample size and reliance on panoramic radiographs, the findings suggest that combining tooth wear and pulp cavity size offers a more robust tool for age estimation in clinical and forensic settings.
5.Abbreviated Breast Magnetic Resonance Imaging: Background, Evidence From Studies, and Future Considerations
Investigative Magnetic Resonance Imaging 2025;29(1):14-22
Conventional full-protocol breast magnetic resonance imaging (MRI) includes T2-weighted imaging and dynamic contrast-enhanced MRI, consisting of pre-contrast and four to six post-contrast T1-weighted images. By contrast, abbreviated breast MRI consists of pre-contrast and a single post-contrast T1-weighted image as core sequences, along with reconstructed subtraction and maximum intensity projection images. Additional sequences, such as T2-weighted imaging, diffusion-weighted imaging, and a second postcontrast T1-weighted image, can be included in the abbreviated protocol based on user preferences; however, the recommended total acquisition time is less than 10 minutes.Using abbreviated MRI, the scan time is reduced, and MRI throughput increases, which can lower costs and improve accessibility. Moreover, the current evidence consistently suggests that the accuracy of abbreviated breast MRI in detecting breast cancer is comparable to that of full-protocol MRI. With these advantages, abbreviated breast MRI may be increasingly used for screening women at average to intermediate risk. This review discusses the background of abbreviated MRI, the results of clinical studies, and outstanding issues for future consideration.
6.Korean Registry on the Current Management of Helicobacter pylori (K-Hp-Reg): Interim Analysis of Adherence to the Revised Evidence-Based Guidelines for First-Line Treatment
Hyo-Joon YANG ; Joon Sung KIM ; Ji Yong AHN ; Ok-Jae LEE ; Gwang Ha KIM ; Chang Seok BANG ; Moo In PARK ; Jae Yong PARK ; Sun Moon KIM ; Su Jin HONG ; Joon Hyun CHO ; Shin Hee KIM ; Hyun Joo SONG ; Jin Woong CHO ; Sam Ryong JEE ; Hyun LIM ; Yong Hwan KWON ; Ju Yup LEE ; Seong Woo JEON ; Seon-Young PARK ; Younghee CHOE ; Moon Kyung JOO ; Dae-Hyun KIM ; Jae Myung PARK ; Beom Jin KIM ; Jong Yeul LEE ; Tae Hoon OH ; Jae Gyu KIM ;
Gut and Liver 2025;19(3):364-375
Background/Aims:
The Korean guidelines for Helicobacter pylori treatment were revised in 2020, however, the extent of adherence to these guidelines in clinical practice remains unclear. Herein, we initiated a prospective, nationwide, multicenter registry study in 2021 to evaluate the current management of H.pylori infection in Korea.
Methods:
This interim report describes the adherence to the revised guidelines and their impact on firstline eradication rates. Data on patient demographics, diagnoses, treatments, and eradication outcomes were collected using a web-based electronic case report form.
Results:
A total of 7,261 patients from 66 hospitals who received first-line treatment were analyzed.The modified intention-to-treat eradication rate for first-line treatment was 81.0%, with 80.4% of the prescriptions adhering to the revised guidelines. The most commonly prescribed regimen was the 14-day clarithromycin-based triple therapy (CTT; 42.0%), followed by tailored therapy (TT; 21.2%), 7-day CTT (14.1%), and 10-day concomitant therapy (CT; 10.1%). Time-trend analysis demonstrated significant increases in guideline adherence and the use of 10-day CT and TT, along with a decrease in the use of 7-day CTT (all p<0.001). Multivariate logistic regression analysis revealed that guideline adherence was significantly associated with first-line eradication success (odds ratio, 2.03; 95% confidence interval, 1.61 to 2.56; p<0.001).
Conclusions
The revised guidelines for the treatment of H. pylori infection have been increasingly adopted in routine clinical practice in Korea, which may have contributed to improved first-line eradication rates. Notably, the 14-day CTT, 10-day CT, and TT regimens are emerging as the preferred first-line treatment options among Korean physicians.
7.Synergistic anticancer effects of mitochondria-targeting peptide combined with paclitaxel in breast cancer cells: a preclinical study
Juneyoung AHN ; Ok-Hee KIM ; Seongeon JIN ; Ja-Hyoung RYU ; Dosang LEE ; Woo-Chan PARK ; Say-June KIM
Annals of Surgical Treatment and Research 2025;108(2):108-123
Purpose:
Mitochondria-accumulating amphiphilic peptide (Mito-FF) was designed to selectively target mitochondria in cancer cells and enhance anticancer effects through its unique structure. Mito-FF consists of (1) diphenylalanine, a β-sheet-forming building block critical for self-assembly; (2) triphenylphosphonium, a mitochondrial targeting moiety guiding the peptide to mitochondria; and (3) pyrene, a fluorescent probe enabling visualization of its accumulation and selfassembly. This study evaluates the anticancer efficacy of Mito-FF in breast cancer cells and explores its combination with paclitaxel, a standard therapy for breast cancer, focusing on its modulation of the epithelial-mesenchymal transition (EMT) pathway.
Methods:
In vitro and in vivo experiments were performed using MCF-7 and MDA-MB-231 breast cancer cell lines and their respective xenograft models. Cell viability, migration, EMT marker expression, and apoptosis-related proteins were analyzed.
Results:
Mito-FF demonstrated superior inhibition of cell viability and migration compared to paclitaxel alone in both cell lines. Combination therapy with Mito-FF and paclitaxel resulted in enhanced reduction of cell viability and migration. EMT markers were significantly modulated, with decreased mesenchymal markers (Snail and vimentin) and increased epithelial marker (E-cadherin) following combination treatment. Furthermore, the combination therapy synergistically elevated proapoptotic markers such as poly (adenosine diphosphate-ribose) polymerase and reduced anti-apoptotic markers such as myeloid cell leukemia 1. In vivo experiments revealed a marked reduction in tumor volume with combination therapy, accompanied by the highest expression levels of E-cadherin and pro-apoptotic marker Bim.
Conclusion
Mito-FF, designed for mitochondrial targeting and visualization, exhibited potent anticancer effects when combined with paclitaxel, in the breast cancer cells.
8.Performance of Digital Mammography-Based Artificial Intelligence Computer-Aided Diagnosis on Synthetic Mammography From Digital Breast Tomosynthesis
Kyung Eun LEE ; Sung Eun SONG ; Kyu Ran CHO ; Min Sun BAE ; Bo Kyoung SEO ; Soo-Yeon KIM ; Ok Hee WOO
Korean Journal of Radiology 2025;26(3):217-229
Objective:
To test the performance of an artificial intelligence-based computer-aided diagnosis (AI-CAD) designed for fullfield digital mammography (FFDM) when applied to synthetic mammography (SM).
Materials and Methods:
We analyzed 501 women (mean age, 57 ± 11 years) who underwent preoperative mammography and breast cancer surgery. This cohort consisted of 1002 breasts, comprising 517 with cancer and 485 without. All patients underwent digital breast tomosynthesis (DBT) and FFDM during the preoperative workup. The SM is routinely reconstructed using DBT. Commercial AI-CAD (Lunit Insight MMG, version 1.1.7.2) was retrospectively applied to SM and FFDM to calculate the abnormality scores for each breast. The median abnormality scores were compared for the 517 breasts with cancer using the Wilcoxon signed-rank test. Calibration curves of abnormality scores were evaluated. The discrimination performance was analyzed using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity using a 10% preset threshold. Sensitivity and specificity were further analyzed according to the mammographic and pathological characteristics.The results of SM and FFDM were compared.
Results:
AI-CAD demonstrated a significantly lower median abnormality score (71% vs. 96%, P < 0.001) and poorer calibration performance for SM than for FFDM. SM exhibited lower sensitivity (76.2% vs. 82.8%, P < 0.001), higher specificity (95.5% vs.91.8%, P < 0.001), and comparable AUC (0.86 vs. 0.87, P = 0.127) than FFDM. SM showed lower sensitivity than FFDM in asymptomatic breasts, dense breasts, ductal carcinoma in situ, T1, N0, and hormone receptor-positive/human epidermal growth factor receptor 2-negative cancers but showed higher specificity in non-cancerous dense breasts.
Conclusion
AI-CAD showed lower abnormality scores and reduced calibration performance for SM than for FFDM.Furthermore, the 10% preset threshold resulted in different discrimination performances for the SM. Given these limitations, off-label application of the current AI-CAD to SM should be avoided.
9.Age Estimation Using Attrition and Pulp Cavity Size of the Mandibular First Molar in Korean Population
Hee-Won KIM ; Hye-Mi JEON ; Kyung-Hee KIM ; Hye-Min JU ; Soo-Min OK ; Sung-Hee JEONG ; Yong-Woo AHN
Korean Journal of Legal Medicine 2025;49(1):1-6
In forensic science, age estimation is essential for identifying both living and deceased individuals. Teeth and jawbones serve as reliable indicators due to their gradual age-related changes and resistance to environmental factors. Among the various methods, attrition and pulp cavity size are commonly used to estimate adult age. This study aimed to enhance the accuracy of age estimation in Korean adults by combining measurements of tooth attrition and pulp cavity size obtained from panoramic radiographs of mandibular first molars. We evaluated 118 patients (62 male, 56 female) who visited Pusan National University Dental Hospital between 2010 and 2024. Radiographs and clinical photographs were analyzed for grade C teeth with exposed dentin using Takei’s method, and the pulp chamber height ratio (PCHR) and width ratio (PCWR) were measured using Jeon’s method. Intraobserver reliability was high (intraclass correlation coefficient>0.6), with no significant sex-based differences in PCHR and PCWR. Both ratios negatively correlated with age, with PCWR showing a stronger correlation, particularly in females (r=–0.606). This study derived an improved age estimation formula with R² values ranging from 0.540 to 0.546 when both PCHR and PCWR were combined. Despite the limitations of this study, such as its small sample size and reliance on panoramic radiographs, the findings suggest that combining tooth wear and pulp cavity size offers a more robust tool for age estimation in clinical and forensic settings.
10.A Case Report on Ductal Carcinoma in situ Arising from Axillary Accessory Breast Tissue
Kyung Eun LEE ; Juhee KANG ; Woo Young KANG ; Ok Hee WOO
Journal of the Korean Society of Radiology 2025;86(1):154-159
Accessory breast tissue can appear along the mammary ridge, extending from the axilla to the groin, with the axilla being the most common site. Malignancies arising in accessory breast tissue are rare, representing approximately 0.3%–0.6% of all breast cancer cases.When evaluating accessory breasts, it is essential to apply the same management strategies used for conventionally positioned breasts. This report presents a case of ductal carcinoma in situ originating from accessory breast tissue in the axilla of a 55-year-old woman. The diagnosis was established through a comprehensive assessment involving mammography, ultrasound, and magnetic resonance imaging. Since the axillary accessory breast tissue wasn’t initially included in the routine mammography, we added an axillary tail view to evaluate the extent and morphology of malignant microcalcifications.

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