1.Biennial Mammography Performance in the Korean National Cancer Screening Program From 2009 to 2020
Dong Jun KIM ; Nan-He YOON ; Jae Kwan JUN ; Mina SUH ; Sunhwa LEE ; Seongju KIM ; Horim A. HWANG ; Seung Eun JUNG ; Hooyeon LEE
Korean Journal of Radiology 2025;26(4):313-323
Objective:
Mammography is essential for reducing breast cancer mortality; however, its performance varies globally. This study aimed to evaluate mammography screening outcomes in Korea over 12 years and investigate regional variations.
Materials and Methods:
We analyzed mammography data from 42 million Korean women, aged 40 years and older, who participated in the Korean National Cancer Screening Program (KNCSP) from 2009 to 2020. Performance metrics—including recall rate (RR), positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), cancer detection rate (CDR), interval cancer rate (ICR), and dense breast rate (DBR), were computed. Twelve-year trends in these metrics were analyzed using Joinpoint regression. Regional variations were also examined across Korea’s 237 districts, stratified by age groups.
Results:
From 2009 to 2020, 42165405 mammography screenings were conducted through the KNCSP, increasing from 2821132 screenings in 2009 to 3596204 in 2020. The RR decreased from 17.2% in 2009 to 11.2% in 2020 (average annual percent change [AAPC] = -3.7%), while the PPV increased from 0.8% to 2.8%; AAPC = 10.7%), the CDR increased from 1.5 to 3.1 per 1000; AAPC = 7.3%), and the ICR rose from 0.9 to 1.6 per 1000; (AAPC = 5.2%). Regional variations were noted; however, differences in the RR, sensitivity, specificity, and FPR decreased over time.
Conclusion
While mammography performance improved from 2009 to 2020, the PPV and sensitivity remain suboptimal, underscoring the need for continuous monitoring. Regional disparities in performance, although reduced, persist. These findings provide essential baseline data for improving mammography quality and addressing inequities in breast cancer screening.
2.Establishing Normative Values for Entire Spinal Cord Morphometrics in East Asian Young Adults
Bio JOO ; Hyung Jun PARK ; Mina PARK ; Sang Hyun SUH ; Sung Jun AHN
Korean Journal of Radiology 2025;26(2):146-155
Objective:
The quantitative assessment of spinal cord volume is still in the early stages of development. Recently, normative morphometric values of the cervical spinal cord have been reported. This study aimed to establish normative values for spinal cord morphometry, extending beyond the cervical region to include the thoracic and lumbar spinal cord, and to examine the influence of sex and ethnicity on these measurements.
Materials and Methods:
This prospective study included 28 young, healthy, East Asian volunteers (14 males and 14 females;mean age, 30.14 ± 4.07 years) who underwent spinal cord MRI using a 3T scanner. The cross-sectional areas (CSAs), anteroposterior (AP) and transverse diameters, and compression ratios of the entire spinal cord were calculated. Additionally, the effects of sex and ethnicity on spinal cord volumetry were evaluated, with the influence of ethnicity assessed by comparing the findings with a Caucasian dataset from the PAM50 study.
Results:
The CSAs demonstrated two enlargements at the cervical and lumbar levels. The cervical enlargement at C4–5 exhibited an elliptical shape, while the lumbar enlargement at T12 appeared more circular. The CSAs and AP and transverse diameters of the spinal cords in males were significantly larger than that of females (P < 0.001). The spinal cord compression ratios in East Asians were significantly lower than those in Caucasians (P < 0.001).
Conclusion
This study revealed that the two spinal cord enlargements exhibit different patterns and suggest significant differences in spinal cord morphometric values according to sex and ethnicity.
3.Biennial Mammography Performance in the Korean National Cancer Screening Program From 2009 to 2020
Dong Jun KIM ; Nan-He YOON ; Jae Kwan JUN ; Mina SUH ; Sunhwa LEE ; Seongju KIM ; Horim A. HWANG ; Seung Eun JUNG ; Hooyeon LEE
Korean Journal of Radiology 2025;26(4):313-323
Objective:
Mammography is essential for reducing breast cancer mortality; however, its performance varies globally. This study aimed to evaluate mammography screening outcomes in Korea over 12 years and investigate regional variations.
Materials and Methods:
We analyzed mammography data from 42 million Korean women, aged 40 years and older, who participated in the Korean National Cancer Screening Program (KNCSP) from 2009 to 2020. Performance metrics—including recall rate (RR), positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), cancer detection rate (CDR), interval cancer rate (ICR), and dense breast rate (DBR), were computed. Twelve-year trends in these metrics were analyzed using Joinpoint regression. Regional variations were also examined across Korea’s 237 districts, stratified by age groups.
Results:
From 2009 to 2020, 42165405 mammography screenings were conducted through the KNCSP, increasing from 2821132 screenings in 2009 to 3596204 in 2020. The RR decreased from 17.2% in 2009 to 11.2% in 2020 (average annual percent change [AAPC] = -3.7%), while the PPV increased from 0.8% to 2.8%; AAPC = 10.7%), the CDR increased from 1.5 to 3.1 per 1000; AAPC = 7.3%), and the ICR rose from 0.9 to 1.6 per 1000; (AAPC = 5.2%). Regional variations were noted; however, differences in the RR, sensitivity, specificity, and FPR decreased over time.
Conclusion
While mammography performance improved from 2009 to 2020, the PPV and sensitivity remain suboptimal, underscoring the need for continuous monitoring. Regional disparities in performance, although reduced, persist. These findings provide essential baseline data for improving mammography quality and addressing inequities in breast cancer screening.
4.Establishing Normative Values for Entire Spinal Cord Morphometrics in East Asian Young Adults
Bio JOO ; Hyung Jun PARK ; Mina PARK ; Sang Hyun SUH ; Sung Jun AHN
Korean Journal of Radiology 2025;26(2):146-155
Objective:
The quantitative assessment of spinal cord volume is still in the early stages of development. Recently, normative morphometric values of the cervical spinal cord have been reported. This study aimed to establish normative values for spinal cord morphometry, extending beyond the cervical region to include the thoracic and lumbar spinal cord, and to examine the influence of sex and ethnicity on these measurements.
Materials and Methods:
This prospective study included 28 young, healthy, East Asian volunteers (14 males and 14 females;mean age, 30.14 ± 4.07 years) who underwent spinal cord MRI using a 3T scanner. The cross-sectional areas (CSAs), anteroposterior (AP) and transverse diameters, and compression ratios of the entire spinal cord were calculated. Additionally, the effects of sex and ethnicity on spinal cord volumetry were evaluated, with the influence of ethnicity assessed by comparing the findings with a Caucasian dataset from the PAM50 study.
Results:
The CSAs demonstrated two enlargements at the cervical and lumbar levels. The cervical enlargement at C4–5 exhibited an elliptical shape, while the lumbar enlargement at T12 appeared more circular. The CSAs and AP and transverse diameters of the spinal cords in males were significantly larger than that of females (P < 0.001). The spinal cord compression ratios in East Asians were significantly lower than those in Caucasians (P < 0.001).
Conclusion
This study revealed that the two spinal cord enlargements exhibit different patterns and suggest significant differences in spinal cord morphometric values according to sex and ethnicity.
5.Amyloid-Related Imaging Abnormalities in Anti-Amyloid Monoclonal Antibody Therapy for Alzheimer’s Disease:Expert Recommendation for Standard MRI Protocol
Jimin KIM ; Eunhee KIM ; Mina PARK ; Yun Jung BAE ; Chong Hyun SUH ; Sung-Hye YOU ; Younghee YIM ; Ho-Joon LEE ; Jin Wook CHOI ; Se Won OH ; Won-Jin MOON ;
Journal of the Korean Society of Radiology 2025;86(1):34-44
The introduction of anti-amyloid therapies for Alzheimer’s disease (AD), such as lecanemab (Lequembi®), which was recently approved in Korea, necessitates careful monitoring for amyloid-related imaging abnormalities (ARIA) using brain MRI. To optimize ARIA monitoring in Korean clinical settings, the Korean Society of Neuroradiology (KSNR) and the Age and Neurodegeneration Imaging (ANDI) Study Group proposed MRI protocol recommendations on essential MR sequences, MRI acquisition parameters, timing and condition of MRI examinations, and essential details to provide a scientific basis for maximizing the safety and efficacy of AD treatment. A customized, standardized MRI protocol focusing on Korea’s healthcare environment can improve ARIA management and ensure patient safety through early detection of potential anti-amyloid therapy side effects, thereby enhancing treatment quality.
6.Cost Utility Analysis of National Cancer Screening Program for Gastric Cancer in Korea: A Markov Model Analysis
Seowoo BAE ; Hyewon LEE ; Eun Young HER ; Kyeongmin LEE ; Joon Sung KIM ; Jeonghoon AHN ; Il Ju CHOI ; Jae Kwan JUN ; Kui Son CHOI ; Mina SUH
Journal of Korean Medical Science 2025;40(6):e43-
Background:
The Korean National Cancer Screening Program (NCSP) for gastric cancer requires economic evaluation due to the low sensitivity of upper gastrointestinal series (UGIs) and the associated low cancer survival rate. This study aimed to ascertain the most cost-effective strategy for the NCSP.
Methods:
The hypothetical target population of this study was aged 40 years or older, and no actual participants were involved. Markov simulation models were constructed for 25 strategies, combinations of 1) screening methods (UGIs or endoscopy vs. endoscopy-only), 2) screening intervals (one, two, or three-year), and 3) upper age limit of screening (69, 74, 79 years old, or “no limit”). Costs, utility, and other input parameters were extracted from various databases and previous studies. Cost-utility, sensitivity, and scenario analyses were conducted.
Results:
The endoscopy-only strategy with a three-year interval with an upper age limit of 69 was the most cost-effective strategy with an incremental cost-utility ratio of KRW 13,354,106 per quality-adjusted life years. According to the probabilistic sensitivity analysis, the uncertainty of the result was significantly small. Scenario analysis is showed that as the screening rate increased, the endoscopy-only strategy saved more costs compared to the current NCSP. Therefore, it is important to maintain a high screening rate when altering the NCSP strategy.
Conclusion
Endoscopy-only screening was more cost-effective method than UGIs for the NCSP. Furthermore, a three-year interval with an upper-age limit of 69 years was the most cost-effective strategy. Efforts to improve cost-effective screening guidelines will support the efficient use of medical resources. Additionally, maintaining a higher screening rate may maximize the impact of the modification in strategy on cost-effectiveness.
7.Cost Utility Analysis of National Cancer Screening Program for Gastric Cancer in Korea: A Markov Model Analysis
Seowoo BAE ; Hyewon LEE ; Eun Young HER ; Kyeongmin LEE ; Joon Sung KIM ; Jeonghoon AHN ; Il Ju CHOI ; Jae Kwan JUN ; Kui Son CHOI ; Mina SUH
Journal of Korean Medical Science 2025;40(6):e43-
Background:
The Korean National Cancer Screening Program (NCSP) for gastric cancer requires economic evaluation due to the low sensitivity of upper gastrointestinal series (UGIs) and the associated low cancer survival rate. This study aimed to ascertain the most cost-effective strategy for the NCSP.
Methods:
The hypothetical target population of this study was aged 40 years or older, and no actual participants were involved. Markov simulation models were constructed for 25 strategies, combinations of 1) screening methods (UGIs or endoscopy vs. endoscopy-only), 2) screening intervals (one, two, or three-year), and 3) upper age limit of screening (69, 74, 79 years old, or “no limit”). Costs, utility, and other input parameters were extracted from various databases and previous studies. Cost-utility, sensitivity, and scenario analyses were conducted.
Results:
The endoscopy-only strategy with a three-year interval with an upper age limit of 69 was the most cost-effective strategy with an incremental cost-utility ratio of KRW 13,354,106 per quality-adjusted life years. According to the probabilistic sensitivity analysis, the uncertainty of the result was significantly small. Scenario analysis is showed that as the screening rate increased, the endoscopy-only strategy saved more costs compared to the current NCSP. Therefore, it is important to maintain a high screening rate when altering the NCSP strategy.
Conclusion
Endoscopy-only screening was more cost-effective method than UGIs for the NCSP. Furthermore, a three-year interval with an upper-age limit of 69 years was the most cost-effective strategy. Efforts to improve cost-effective screening guidelines will support the efficient use of medical resources. Additionally, maintaining a higher screening rate may maximize the impact of the modification in strategy on cost-effectiveness.
8.Amyloid-Related Imaging Abnormalities in Anti-Amyloid Monoclonal Antibody Therapy for Alzheimer’s Disease:Expert Recommendation for Standard MRI Protocol
Jimin KIM ; Eunhee KIM ; Mina PARK ; Yun Jung BAE ; Chong Hyun SUH ; Sung-Hye YOU ; Younghee YIM ; Ho-Joon LEE ; Jin Wook CHOI ; Se Won OH ; Won-Jin MOON ;
Journal of the Korean Society of Radiology 2025;86(1):34-44
The introduction of anti-amyloid therapies for Alzheimer’s disease (AD), such as lecanemab (Lequembi®), which was recently approved in Korea, necessitates careful monitoring for amyloid-related imaging abnormalities (ARIA) using brain MRI. To optimize ARIA monitoring in Korean clinical settings, the Korean Society of Neuroradiology (KSNR) and the Age and Neurodegeneration Imaging (ANDI) Study Group proposed MRI protocol recommendations on essential MR sequences, MRI acquisition parameters, timing and condition of MRI examinations, and essential details to provide a scientific basis for maximizing the safety and efficacy of AD treatment. A customized, standardized MRI protocol focusing on Korea’s healthcare environment can improve ARIA management and ensure patient safety through early detection of potential anti-amyloid therapy side effects, thereby enhancing treatment quality.
9.Biennial Mammography Performance in the Korean National Cancer Screening Program From 2009 to 2020
Dong Jun KIM ; Nan-He YOON ; Jae Kwan JUN ; Mina SUH ; Sunhwa LEE ; Seongju KIM ; Horim A. HWANG ; Seung Eun JUNG ; Hooyeon LEE
Korean Journal of Radiology 2025;26(4):313-323
Objective:
Mammography is essential for reducing breast cancer mortality; however, its performance varies globally. This study aimed to evaluate mammography screening outcomes in Korea over 12 years and investigate regional variations.
Materials and Methods:
We analyzed mammography data from 42 million Korean women, aged 40 years and older, who participated in the Korean National Cancer Screening Program (KNCSP) from 2009 to 2020. Performance metrics—including recall rate (RR), positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), cancer detection rate (CDR), interval cancer rate (ICR), and dense breast rate (DBR), were computed. Twelve-year trends in these metrics were analyzed using Joinpoint regression. Regional variations were also examined across Korea’s 237 districts, stratified by age groups.
Results:
From 2009 to 2020, 42165405 mammography screenings were conducted through the KNCSP, increasing from 2821132 screenings in 2009 to 3596204 in 2020. The RR decreased from 17.2% in 2009 to 11.2% in 2020 (average annual percent change [AAPC] = -3.7%), while the PPV increased from 0.8% to 2.8%; AAPC = 10.7%), the CDR increased from 1.5 to 3.1 per 1000; AAPC = 7.3%), and the ICR rose from 0.9 to 1.6 per 1000; (AAPC = 5.2%). Regional variations were noted; however, differences in the RR, sensitivity, specificity, and FPR decreased over time.
Conclusion
While mammography performance improved from 2009 to 2020, the PPV and sensitivity remain suboptimal, underscoring the need for continuous monitoring. Regional disparities in performance, although reduced, persist. These findings provide essential baseline data for improving mammography quality and addressing inequities in breast cancer screening.
10.Establishing Normative Values for Entire Spinal Cord Morphometrics in East Asian Young Adults
Bio JOO ; Hyung Jun PARK ; Mina PARK ; Sang Hyun SUH ; Sung Jun AHN
Korean Journal of Radiology 2025;26(2):146-155
Objective:
The quantitative assessment of spinal cord volume is still in the early stages of development. Recently, normative morphometric values of the cervical spinal cord have been reported. This study aimed to establish normative values for spinal cord morphometry, extending beyond the cervical region to include the thoracic and lumbar spinal cord, and to examine the influence of sex and ethnicity on these measurements.
Materials and Methods:
This prospective study included 28 young, healthy, East Asian volunteers (14 males and 14 females;mean age, 30.14 ± 4.07 years) who underwent spinal cord MRI using a 3T scanner. The cross-sectional areas (CSAs), anteroposterior (AP) and transverse diameters, and compression ratios of the entire spinal cord were calculated. Additionally, the effects of sex and ethnicity on spinal cord volumetry were evaluated, with the influence of ethnicity assessed by comparing the findings with a Caucasian dataset from the PAM50 study.
Results:
The CSAs demonstrated two enlargements at the cervical and lumbar levels. The cervical enlargement at C4–5 exhibited an elliptical shape, while the lumbar enlargement at T12 appeared more circular. The CSAs and AP and transverse diameters of the spinal cords in males were significantly larger than that of females (P < 0.001). The spinal cord compression ratios in East Asians were significantly lower than those in Caucasians (P < 0.001).
Conclusion
This study revealed that the two spinal cord enlargements exhibit different patterns and suggest significant differences in spinal cord morphometric values according to sex and ethnicity.

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