1.Long-Term Pulmonary Function and Radiologic Abnormalities Up to 3 Years After COVID-19:A Systematic Review and Meta-Analysis
Jiyoung SONG ; Jong Hyuk LEE ; Hyungin PARK ; Myoung-Jin JANG ; Soon Ho YOON
Korean Journal of Radiology 2026;27(2):174-185
Objective:
To systematically evaluate the long-term trajectory of pulmonary function test (PFT) and CT findings in COVID-19 survivors.
Materials and Methods:
A systematic literature search of PubMed and EMBASE was performed to identify studies published from January 2020 to June 2024 reporting PFT and/or chest CT outcomes at ≥6 months post-COVID-19, up to 36 months. The reference lists of relevant articles were also manually reviewed. Two investigators independently extracted study characteristics, patient demographics, and PFT and CT outcomes at prespecified follow-up intervals (6, 12, 24, and 36 months). Multivariate meta-analyses were conducted to evaluate temporal trends in lung function and radiological abnormalities. Sensitivity analyses, including stratification by disease severity and pooled analyses of studies with multiple follow-up time points, were performed to confirm the robustness of the findings.
Results:
In total, 152 studies (n = 25,766; mean age, 56.7 ± 13.2 years; 14,999 men) were included: 133 reporting PFT outcomes and 80 reporting CT findings. Diffusion capacity (DLCO) impairment was the most common abnormality, showing gradual improvement from 42% at 6 months to 35% at 36 months (P = 0.008) with a corresponding increase in the % predicted DLCO. Similarly, the prevalence of forced vital capacity (FVC) impairment decreased over time, accompanied by an increase in the % predicted FVC. On chest CT, the proportion of patients with no relevant findings remained stable at 30%–40% (P = 0.14).The prevalence of ground-glass opacities (GGO) decreased from 32% at 6 months to 20% at 36 months (P = 0.01), while that of fibrosis persisted at 27%–47% without a significant change (P = 0.28). Subgroup analysis based on disease severity revealed similar temporal trends in both low-severity and high-severity cohorts.
Conclusion
DLCO, FVC, and GGO findings improved gradually up to 36 months post-COVID-19; however, over one-third of the patients continued to exhibit reduced DLCO. Fibrosis persists with limited evidence of resolution over a 3-year period, suggesting a stable but nonprogressive pattern.
2.Association of Shorter Time to Recurrence and Recurrence-Free Survival with Transthoracic Lung Biopsy in Stage I Lung Cancer
Kum Ju CHAE ; Hyunsook HONG ; Hyungin PARK ; Soon Ho YOON
Cancer Research and Treatment 2025;57(2):387-400
Purpose:
We aim to determine whether preoperative percutaneous needle aspiration or biopsy (PCNA/Bx) increases recurrence risk and reduces survival in stage I lung cancer patients, using a nationwide lung cancer registry.
Materials and Methods:
We retrospectively included 3,452 patients diagnosed with stage I lung cancer who underwent curative surgery between 2014 and 2019, as recorded in the Korean Association of Lung Cancer Registry. To balance the characteristics of patients with and without PCNA/Bx, we applied inverse probability of treatment weighting. We used cumulative incidence plots and a weighted subdistribution hazard model to analyze time to recurrence. Recurrence-free survival and overall survival were analyzed using Kaplan-Meier curves and weighted Cox proportional hazard ratio models.
Results:
In patients with adenocarcinoma, the use of PCNA/Bx was associated with a 1.9-fold increase (95% confidence interval [CI], 1.5 to 2.4) in the risk of recurrence and a 1.7-fold decrease (95% CI, 1.3 to 2.2) in recurrence-free survival. Subgroup analysis based on pathologic pleural invasion revealed that the risk of recurrence increased when PCNA/Bx was performed, with 2.1-fold (95% CI, 1.5 to 2.8) in patients without pleural invasion and 1.6-fold (95% CI, 1.0 to 2.4) in those with pleural invasion. No association was found between the use of PCNA/Bx and overall survival.
Conclusion
Preoperative PCNA/Bx was associated with increased recurrence risks in stage I adenocarcinoma, regardless of pathologic pleural invasion status. In early lung cancer cases where adenocarcinoma is strongly suspected and curative surgery is feasible, the use of transthoracic biopsy should be approached with caution.
3.Association of Shorter Time to Recurrence and Recurrence-Free Survival with Transthoracic Lung Biopsy in Stage I Lung Cancer
Kum Ju CHAE ; Hyunsook HONG ; Hyungin PARK ; Soon Ho YOON
Cancer Research and Treatment 2025;57(2):387-400
Purpose:
We aim to determine whether preoperative percutaneous needle aspiration or biopsy (PCNA/Bx) increases recurrence risk and reduces survival in stage I lung cancer patients, using a nationwide lung cancer registry.
Materials and Methods:
We retrospectively included 3,452 patients diagnosed with stage I lung cancer who underwent curative surgery between 2014 and 2019, as recorded in the Korean Association of Lung Cancer Registry. To balance the characteristics of patients with and without PCNA/Bx, we applied inverse probability of treatment weighting. We used cumulative incidence plots and a weighted subdistribution hazard model to analyze time to recurrence. Recurrence-free survival and overall survival were analyzed using Kaplan-Meier curves and weighted Cox proportional hazard ratio models.
Results:
In patients with adenocarcinoma, the use of PCNA/Bx was associated with a 1.9-fold increase (95% confidence interval [CI], 1.5 to 2.4) in the risk of recurrence and a 1.7-fold decrease (95% CI, 1.3 to 2.2) in recurrence-free survival. Subgroup analysis based on pathologic pleural invasion revealed that the risk of recurrence increased when PCNA/Bx was performed, with 2.1-fold (95% CI, 1.5 to 2.8) in patients without pleural invasion and 1.6-fold (95% CI, 1.0 to 2.4) in those with pleural invasion. No association was found between the use of PCNA/Bx and overall survival.
Conclusion
Preoperative PCNA/Bx was associated with increased recurrence risks in stage I adenocarcinoma, regardless of pathologic pleural invasion status. In early lung cancer cases where adenocarcinoma is strongly suspected and curative surgery is feasible, the use of transthoracic biopsy should be approached with caution.
4.Association of Shorter Time to Recurrence and Recurrence-Free Survival with Transthoracic Lung Biopsy in Stage I Lung Cancer
Kum Ju CHAE ; Hyunsook HONG ; Hyungin PARK ; Soon Ho YOON
Cancer Research and Treatment 2025;57(2):387-400
Purpose:
We aim to determine whether preoperative percutaneous needle aspiration or biopsy (PCNA/Bx) increases recurrence risk and reduces survival in stage I lung cancer patients, using a nationwide lung cancer registry.
Materials and Methods:
We retrospectively included 3,452 patients diagnosed with stage I lung cancer who underwent curative surgery between 2014 and 2019, as recorded in the Korean Association of Lung Cancer Registry. To balance the characteristics of patients with and without PCNA/Bx, we applied inverse probability of treatment weighting. We used cumulative incidence plots and a weighted subdistribution hazard model to analyze time to recurrence. Recurrence-free survival and overall survival were analyzed using Kaplan-Meier curves and weighted Cox proportional hazard ratio models.
Results:
In patients with adenocarcinoma, the use of PCNA/Bx was associated with a 1.9-fold increase (95% confidence interval [CI], 1.5 to 2.4) in the risk of recurrence and a 1.7-fold decrease (95% CI, 1.3 to 2.2) in recurrence-free survival. Subgroup analysis based on pathologic pleural invasion revealed that the risk of recurrence increased when PCNA/Bx was performed, with 2.1-fold (95% CI, 1.5 to 2.8) in patients without pleural invasion and 1.6-fold (95% CI, 1.0 to 2.4) in those with pleural invasion. No association was found between the use of PCNA/Bx and overall survival.
Conclusion
Preoperative PCNA/Bx was associated with increased recurrence risks in stage I adenocarcinoma, regardless of pathologic pleural invasion status. In early lung cancer cases where adenocarcinoma is strongly suspected and curative surgery is feasible, the use of transthoracic biopsy should be approached with caution.
5.Clinical Assessments and MRI Findings Suggesting Early Surgical Treatment for Patients with Medial Epicondylitis
Hyungin PARK ; Seok HAHN ; Jisook YI ; Jin-Young BANG ; Youngbok KIM ; Hyung Kyung JUNG ; Jiyeon BAIK
Journal of the Korean Radiological Society 2021;82(3):613-625
Purpose:
To evaluate the MRI findings and clinical factors that are characteristic of patients who ultimately undergo surgery for medial epicondylitis.
Materials and Methods:
Fifty-two consecutive patients who were diagnosed with medial epicondylitis and underwent an elbow MRI between March 2010 and December 2018 were included in this retrospective study. The patients’ demographic information, clinical data, and MRI findings were evaluated. All variables were compared between the conservative treatment and surgical treatment groups. Logistic regression analyses were conducted to identify which factors were associated with surgical treatment.
Results:
Common flexor tear (CFT) tear size showed a statistically significant difference in both the transverse and longitudinal planes (p < 0.001, p = 0.013). The CFT abnormality grade significantly differed in both the transverse and longitudinal planes (p = 0.022, p = 0.003). A significant difference was also found in the medial collateral ligament abnormality (p = 0.025). Logistic regression analyses showed that only the transverse diameter of the CFT tear size (odds ratio:1.864; 95% confidence interval: 1.264–2.750) was correlated with surgical treatment.
Conclusion
Of patients diagnosed with medial epicondylitis, patients with a larger transverse CFT tear size tend to undergo surgical treatment ultimately.
6.Clinical Assessments and MRI Findings Suggesting Early Surgical Treatment for Patients with Medial Epicondylitis
Hyungin PARK ; Seok HAHN ; Jisook YI ; Jin-Young BANG ; Youngbok KIM ; Hyung Kyung JUNG ; Jiyeon BAIK
Journal of the Korean Radiological Society 2021;82(3):613-625
Purpose:
To evaluate the MRI findings and clinical factors that are characteristic of patients who ultimately undergo surgery for medial epicondylitis.
Materials and Methods:
Fifty-two consecutive patients who were diagnosed with medial epicondylitis and underwent an elbow MRI between March 2010 and December 2018 were included in this retrospective study. The patients’ demographic information, clinical data, and MRI findings were evaluated. All variables were compared between the conservative treatment and surgical treatment groups. Logistic regression analyses were conducted to identify which factors were associated with surgical treatment.
Results:
Common flexor tear (CFT) tear size showed a statistically significant difference in both the transverse and longitudinal planes (p < 0.001, p = 0.013). The CFT abnormality grade significantly differed in both the transverse and longitudinal planes (p = 0.022, p = 0.003). A significant difference was also found in the medial collateral ligament abnormality (p = 0.025). Logistic regression analyses showed that only the transverse diameter of the CFT tear size (odds ratio:1.864; 95% confidence interval: 1.264–2.750) was correlated with surgical treatment.
Conclusion
Of patients diagnosed with medial epicondylitis, patients with a larger transverse CFT tear size tend to undergo surgical treatment ultimately.

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