1.Comparative Outcomes of No-Touch Radiofrequency Ablation Versus Tumor-Puncture Microwave Ablation for Small Hepatocellular Carcinoma
Jae Hyun KIM ; Sae-Jin PARK ; Dong Jin CHUNG ; Hyun Pyo HONG ; Jeong Kyong LEE ; Chang Jin YOON ; Jeong Min LEE
Korean Journal of Radiology 2026;27(1):34-47
Objective:
This study aimed to compare the therapeutic outcomes of no-touch (NT) radiofrequency ablation (RFA) vs. tumorpuncture microwave ablation (MWA) in the treatment of single hepatocellular carcinomas (HCCs) measuring ≤3 cm.
Materials and Methods:
This multicenter retrospective study included 304 patients who underwent either NT-RFA (n = 144) or MWA (n = 160) for a single HCC measuring ≤3 cm. Comparative analyses were conducted for the overall cohort, while 81 patients per group were matched using propensity score matching (PSM). The analyzed outcomes included technical success, primary technique efficacy, local tumor progression (LTP), and major complications. Cumulative LTP was estimated using Kaplan–Meier analysis and compared using the log-rank text, while the rate of ablative margin ≥5 mm and ablation time were compared using Chi-squared and Mann–Whitney U tests, respectively.
Results:
Technical success was achieved in 98.6% (142/144) and 100% (160/160) of in the NT-RFA and MWA patients, respectively before PSM (P = 0.224), and 98.8% (80/81) and 100% (81/81) after PSM (P = 1.000). The primary technique efficacies were 98.6% (142/144) and 100% (160/160) before PSM (P = 0.224), and 97.5 % (79/81) and 100% (81/81) after PSM (P = 0.497), respectively. The 1-, 2-, and 3-year cumulative LTP rates were 1.4%, 1.4%, and 2.3%, respectively, for NTRFA and 5.1%, 8.6%, and 8.6%, respectively, for MWA before PSM (P = 0.013). After PSM, the corresponding rates were 0%, 0%, and 0% for NT-RFA, and 7.6%, 10.4%, and 10.4% for MWA (P = 0.006). Major complications were not observed. NT-RFA achieved a higher proportion, with an ablative margin ≥5 mm (88.7% [126/142] vs. 71.9% [115/160]; P < 0.001), but required longer ablation times (median, 10.0 vs. 6.0 min; P < 0.001).
Conclusion
NT-RFA showed superior local tumor control compared to MWA, despite greater procedural complexity and longer ablation times.
2.Recent advances in single-port robotic thyroidectomy:evolution, techniques, and clinical outcomes
Jin Kyong KIM ; Dong Wook KIM ; Jae Sang RYU ; Sungkeun KANG ; Eun Jin KIM ; Sang-Wook KANG ; Jong Ju JEONG ; Kee-Hyun NAM ; Woong Youn CHUNG
Annals of Surgical Treatment and Research 2026;110(1):3-11
Robotic thyroidectomy has progressed from multiport to single-port (SP) platforms to minimize invasiveness and improve cosmesis. The da Vinci SP system (Intuitive Surgical) combines a flexible 3-dimensional endoscope with 3 wristed instruments in a single 2.5-cm cannula-enabled concealed remote access route and mitigates external arm collisions.This review synthesized PubMed-indexed reports (2020–2025) on SP robotic thyroidectomy using the following approaches:transaxillary variants, SP areolar, retroauricular/facelift (SP-hairline variants), and transoral approach. We focused on technical refinement, learning curves, and clinical outcomes. We highlight technical refinements and clinical outcomes across access routes. Contemporary series indicate that SP thyroidectomy is feasible and safe in well-selected patients, with high cosmetic satisfaction and operative metrics comparable to those of multiport cohorts. Among the SP routes, transaxillary variants have the most mature peer-reviewed reporting and are therefore discussed in greater detail. Early applications of SP-assisted lateral neck dissection have also been described. The limitations of current SP platforms include constrained counter-traction, reduced internal workspace, and incomplete integration of advanced energy devices.Nonetheless, ongoing device innovations and the growing global experience suggest that SP systems will increasingly shape endocrine neck surgeries.
3.The Incidence of Occult Malignancy in Contralateral Risk Reducing Mastectomy Among Affected Breast Cancer Gene Mutation Carriers in South Korea
Cho Eun LEE ; Dong Seung SHIN ; Ki Jo KIM ; Seok Jin NAM ; Seok Won KIM ; Jonghan YU ; Byung Joo CHAE ; Se Kyung LEE ; Jai Min RYU ; Goo-Hyun MUN ; Jai-Kyong PYON ; Byung-Joon JEON ; Kyongje WOO ; Jeong Eon LEE
Journal of Breast Cancer 2025;28(1):1-10
Purpose:
Breast cancer gene (BRCA) mutation is a well-known risk factor for breast cancer, and clinical interest in prophylactic mastectomy has increased in recent years.We investigated patients who were BRCA mutation carriers and underwent contralateral risk-reducing mastectomy (RRM), focusing on the incidence of occult malignancy after contralateral RRM.
Methods:
Prospectively collected data of patients with breast cancer treated at a single institution were retrospectively reviewed. Patients who underwent RRM with BRCA mutation who underwent RRM between January 2010 and November 2023 were included in this study.Among patients who underwent contralateral RRM, those with a primary cancer diagnosis were included, and those with occult malignancy on the contralateral RRM side were reviewed additionally. The demographics and pathologies of both primary breast cancer and occult malignancies were evaluated.
Results:
In our institution, 925 patients were identified as BRCA mutation carriers, and 320 patients underwent contralateral RRM along with primary breast cancer surgery. BRCA2 mutation occurred more frequently (54.8%) in the overall BRCA mutation cohort. Furthermore, we reviewed 320 patients diagnosed with breast cancer and detected as BRCA mutation carriers who underwent contralateral RRM; high proportion of them were BRCA1 mutation carriers.Interestingly, we found a low incidence of only seven patients (2.2%) with occult malignancy on contralateral RRM side, which is different from that reported in other nations.
Conclusion
The incidence of occult malignancy in the contralateral breast of breast cancer patients with breast cancer with BRCA mutation is significantly low, and may be influenced by several factors. Increased utilization of screening and advancements in diagnostic technologies in South Korea have reduced the chance of occult malignancy in RRM, and a variety of pathologic examination methods may affect the rate of incidence.
4.The Incidence of Occult Malignancy in Contralateral Risk Reducing Mastectomy Among Affected Breast Cancer Gene Mutation Carriers in South Korea
Cho Eun LEE ; Dong Seung SHIN ; Ki Jo KIM ; Seok Jin NAM ; Seok Won KIM ; Jonghan YU ; Byung Joo CHAE ; Se Kyung LEE ; Jai Min RYU ; Goo-Hyun MUN ; Jai-Kyong PYON ; Byung-Joon JEON ; Kyongje WOO ; Jeong Eon LEE
Journal of Breast Cancer 2025;28(1):1-10
Purpose:
Breast cancer gene (BRCA) mutation is a well-known risk factor for breast cancer, and clinical interest in prophylactic mastectomy has increased in recent years.We investigated patients who were BRCA mutation carriers and underwent contralateral risk-reducing mastectomy (RRM), focusing on the incidence of occult malignancy after contralateral RRM.
Methods:
Prospectively collected data of patients with breast cancer treated at a single institution were retrospectively reviewed. Patients who underwent RRM with BRCA mutation who underwent RRM between January 2010 and November 2023 were included in this study.Among patients who underwent contralateral RRM, those with a primary cancer diagnosis were included, and those with occult malignancy on the contralateral RRM side were reviewed additionally. The demographics and pathologies of both primary breast cancer and occult malignancies were evaluated.
Results:
In our institution, 925 patients were identified as BRCA mutation carriers, and 320 patients underwent contralateral RRM along with primary breast cancer surgery. BRCA2 mutation occurred more frequently (54.8%) in the overall BRCA mutation cohort. Furthermore, we reviewed 320 patients diagnosed with breast cancer and detected as BRCA mutation carriers who underwent contralateral RRM; high proportion of them were BRCA1 mutation carriers.Interestingly, we found a low incidence of only seven patients (2.2%) with occult malignancy on contralateral RRM side, which is different from that reported in other nations.
Conclusion
The incidence of occult malignancy in the contralateral breast of breast cancer patients with breast cancer with BRCA mutation is significantly low, and may be influenced by several factors. Increased utilization of screening and advancements in diagnostic technologies in South Korea have reduced the chance of occult malignancy in RRM, and a variety of pathologic examination methods may affect the rate of incidence.
5.The Incidence of Occult Malignancy in Contralateral Risk Reducing Mastectomy Among Affected Breast Cancer Gene Mutation Carriers in South Korea
Cho Eun LEE ; Dong Seung SHIN ; Ki Jo KIM ; Seok Jin NAM ; Seok Won KIM ; Jonghan YU ; Byung Joo CHAE ; Se Kyung LEE ; Jai Min RYU ; Goo-Hyun MUN ; Jai-Kyong PYON ; Byung-Joon JEON ; Kyongje WOO ; Jeong Eon LEE
Journal of Breast Cancer 2025;28(1):1-10
Purpose:
Breast cancer gene (BRCA) mutation is a well-known risk factor for breast cancer, and clinical interest in prophylactic mastectomy has increased in recent years.We investigated patients who were BRCA mutation carriers and underwent contralateral risk-reducing mastectomy (RRM), focusing on the incidence of occult malignancy after contralateral RRM.
Methods:
Prospectively collected data of patients with breast cancer treated at a single institution were retrospectively reviewed. Patients who underwent RRM with BRCA mutation who underwent RRM between January 2010 and November 2023 were included in this study.Among patients who underwent contralateral RRM, those with a primary cancer diagnosis were included, and those with occult malignancy on the contralateral RRM side were reviewed additionally. The demographics and pathologies of both primary breast cancer and occult malignancies were evaluated.
Results:
In our institution, 925 patients were identified as BRCA mutation carriers, and 320 patients underwent contralateral RRM along with primary breast cancer surgery. BRCA2 mutation occurred more frequently (54.8%) in the overall BRCA mutation cohort. Furthermore, we reviewed 320 patients diagnosed with breast cancer and detected as BRCA mutation carriers who underwent contralateral RRM; high proportion of them were BRCA1 mutation carriers.Interestingly, we found a low incidence of only seven patients (2.2%) with occult malignancy on contralateral RRM side, which is different from that reported in other nations.
Conclusion
The incidence of occult malignancy in the contralateral breast of breast cancer patients with breast cancer with BRCA mutation is significantly low, and may be influenced by several factors. Increased utilization of screening and advancements in diagnostic technologies in South Korea have reduced the chance of occult malignancy in RRM, and a variety of pathologic examination methods may affect the rate of incidence.
6.Reframing Research Ethics in the Age of Generative Artificial Intelligence:Key Issues and Practical Proposals
Korean Journal of Medical Ethics 2025;28(4):279-292
This article explores how the traditional framework of research ethics must be redefined in response to the ethical challenges posed by the academic use of generative artificial intelligence (Gen AI).As Gen AI technologies become increasingly integrated across various stages of research—from study design and data analysis to manuscript writing—they offer notable gains in efficiency, while simultaneously expanding ethical gray areas. In particular, issues such as factual inaccuracies and hallucinations, violations of privacy and copyright, ambiguous authorship, and the deskilling of researchers are becoming increasingly entangled, posing serious threats to the credibility and integrity of academic work. To address these concerns, the article proposes four core ethical principles suited to the Gen AI era: truthfulness and explainability, respect for intellectual property, field-specific guidelines, and the cultivation of researcher competence. The central concern is not merely whether such technologies should be adopted, but rather how the identity and responsibility of researchers, and the sustainability of scholarly communities, can be ethically restructured in the face of transformative technological change.
7.Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part I. Initial Management of Differentiated Thyroid Cancers - Chapter 5. Evaluation of Recurrence Risk Postoperatively and Initial Risk Stratification in Differentiated Thyroid Cancer 2024
Eun Kyung LEE ; Young Shin SONG ; Ho-Cheol KANG ; Sun Wook KIM ; Dong Gyu NA ; Shin Je MOON ; Dong-Jun LIM ; Kyong Yeun JUNG ; Yun Jae CHUNG ; Chan Kwon JUNG ; Young Joo PARK ;
International Journal of Thyroidology 2025;18(1):111-112
8.2025 Korean Thyroid Association Clinical Management Guideline on Active Surveillance for Low-Risk Papillary Thyroid Carcinoma
Eun Kyung LEE ; Min Joo KIM ; Seung Heon KANG ; Bon Seok KOO ; Kyungsik KIM ; Mijin KIM ; Bo Hyun KIM ; Ji-hoon KIM ; Shin Je MOON ; Kyorim BACK ; Young Shin SONG ; Jong-hyuk AHN ; Hwa Young AHN ; Ho-Ryun WON ; Won Sang YOO ; Min Kyoung LEE ; Jeongmin LEE ; Ji Ye LEE ; Kyong Yeun JUNG ; Chan Kwon JUNG ; Yoon Young CHO ; Dong-Jun LIM ; Sun Wook KIM ; Young Joo PARK ; Dong Gyu NA ; Jee Soo KIM
International Journal of Thyroidology 2025;18(1):30-64
The increasing detection of papillary thyroid microcarcinoma (PTMC) has raised concerns about overtreatment.For low-risk PTMC, either immediate surgery or active surveillance (AS) can be considered. To support AS implementation, the Korean Thyroid Association convened a multidisciplinary panel and developed the first Korean guideline. AS is recommended to adults with pathologically proven Bethesda V-VI PTMC without clinical evidence of lymph node or distant metastasis, gross extrathyroidal extension, tracheal or recurrent laryngeal nerve invasion, or aggressive histology. Baseline assessment requires high‑resolution cervical ultrasound by experienced operators to rule out extrathyroidal extension, tracheal or recurrent laryngeal nerve invasion, and lymph node metastasis;contrast‑enhanced neck computed tomography is optional. Patient characteristics such as age, comorbidities, and capacity for long-term follow-up should be assessed. Shared decision-making should weigh the benefits and risks of surgery and AS, expected oncologic outcomes, complications, quality of life, anxiety, medical cost, and patient preference. Follow-up includes cervical ultrasound and thyroid function test every six months for two years, then annually. Disease progression, defined as significant tumor growth or newly detected nodal or distant metastasis, warrants surgery. Despite remaining uncertainties, this guideline offers a framework to ensure oncologic safety and support patient-centered active surveillance.
9.Erratum to: Corrigendum: 2023 Korean Society of Menopause -Osteoporosis Guidelines Part I
Dong Ock LEE ; Yeon Hee HONG ; Moon Kyoung CHO ; Young Sik CHOI ; Sungwook CHUN ; Youn-Jee CHUNG ; Seung Hwa HONG ; Kyu Ri HWANG ; Jinju KIM ; Hoon KIM ; Dong-Yun LEE ; Sa Ra LEE ; Hyun-Tae PARK ; Seok Kyo SEO ; Jung-Ho SHIN ; Jae Yen SONG ; Kyong Wook YI ; Haerin PAIK ; Ji Young LEE
Journal of Menopausal Medicine 2024;30(3):179-179
10.Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part I. Initial Management of Differentiated Thyroid Cancers - Chapter 5. Evaluation of Recurrence Risk Postoperatively and Initial Risk Stratification in Differentiated Thyroid Cancer 2024
Eun Kyung LEE ; Young Shin SONG ; Ho-Cheol KANG ; Sun Wook KIM ; Dong Gyu NA ; Shin Je MOON ; Dong-Jun LIM ; Kyong Yeun JUNG ; Yun Jae CHUNG ; Chan Kwon JUNG ; Young Joo PARK ;
International Journal of Thyroidology 2024;17(1):68-96
The American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) staging classification of thyroid cancer can predict death but cannot determine the type and frequency of follow-up testing. Risk stratification is a concept proposed by the American Thyroid Association that uses additional prognostic factors that are not included in the AJCC/UICC classification, such as number or size of metastatic lymph nodes, genetic mutations, and vascular invasion in follicular cancer, to further refine the prognosis of thyroid cancer. The risk of recurrence was categorized as low, intermediate, and high risk, and the need for total thyroidectomy, radioiodine therapy, or thyroid-stimulating hormone suppression was determined depending on each risk level. This approach has been accepted worldwide, and the previous recommendations of the Korean Thyroid Association followed a similar line of thinking but these have been modified in the revised 2024 guidelines.For the revised initial risk stratification, after careful review of the results of the recent meta-analyses and large observational studies and after a multidisciplinary meeting, four major changes were made: 1) thyroid cancer was reclassified according to the World Health Organization (WHO) 2022 tumor classification system; 2) recurrence risk was stratified by combining encapsulated follicular variant papillary thyroid cancer, follicular thyroid cancer, and oncocytic thyroid cancer, which have similar recurrence risk and associated factors, into follicular-patterned tumor; 3) low-risk groups were defined as those with a known recurrence rate of ≤5%, high-risk groups were upgraded to those with a known recurrence rate of ≥30%, and intermediate-risk groups were those with a recurrence risk of 5–30%; and 4) the intermediate risk group had the recurrence rate presented according to various clinicopathological factors, mainly based on reports from Korea. Thus, it is recommended to evaluate the initial risk group by predicting the recurrence rate by combining each clinical factor in individual patients, rather than applying the recurrence rate caused by single risk factor.

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