1.Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part II. Follow-up Surveillance after Initial Treatment 2026
Eun Kyung LEE ; Seung Heon KANG ; Bon Seok KOO ; Mijin KIM ; Min Joo KIM ; Bo Hyun KIM ; Ji Won KIM ; Dong Gyu NA ; Sohyun PARK ; Ji-In BANG ; Kyorim BACK ; Youngduk SEO ; Young-Ik SON ; Young Shin SONG ; Dong Yeob SHIN ; Jong-Hyuk AHN ; Hwa Young AHN ; So Won OH ; Ho-Ryun WON ; Won Sang YOO ; Min Kyoung LEE ; Sang-Woo LEE ; Jeongmin LEE ; Ji Ye LEE ; Dong-Jun LIM ; Ki-Wook CHUNG ; Ari CHONG ; Jin Hyang JUNG ; Sun Wook CHO ; Yoon Young CHO ; Chae Moon HONG ; Young Joo PARK ;
International Journal of Thyroidology 2026;19(1):1-40
In patients with differentiated thyroid cancer (DTC), initial recurrence risk stratification based on clinical, histopathological, and perioperative data remains the key determinant for guiding management strategies during the first 1-2 years post-treatment. However, the adoption of ongoing risk stratification (ORS), which dynamically reassesses risk by integrating longitudinal clinical data and treatment response, enables more precise long-term prognostic assessment and facilitates highly individualized management. Building upon recent guidelines, the 2026 KTA guideline has been further refined by incorporating robust evidence from large-scale national cohorts and comprehensive systematic reviews. These updated recommendations outline contemporary concepts of ORS, risk-adapted TSH suppression targets, optimized surveillance modalities for recurrence detection, and disease-specific long-term follow-up strategies. Reflecting the paradigm shift toward de-escalated treatment, this revision integrates evolved perspectives on TSH suppression intensity, the clinical interpretation of thyroglobulin levels, and tailored follow-up intervals. These evidence-based recommendations aim to minimize unnecessary treatment and excessive surveillance in the large proportion of patients with excellent prognosis after initial therapy, while ensuring that each patient receives appropriately tailored and effective long-term management.
2.Improving breast ultrasonography education: the impact of AI-based decision support on the performance of non-specialist medical professionals
Sangwon LEE ; Hye Sun LEE ; Eunju LEE ; Won Hwa KIM ; Jaeil KIM ; Jung Hyun YOON
Ultrasonography 2025;44(2):124-133
Purpose:
This study evaluated the educational impact of an artificial intelligence (AI)–based decision support system for breast ultrasonography (US) on medical professionals not specialized in breast imaging.
Methods:
In this multi-case, multi-reader study, educational materials, including American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) descriptors, were provided alongside corresponding AI results during training. The AI system presented results in the form of AIheatmaps, AI scores, and AI-provided BI-RADS assessment categories. Forty-two readers evaluated the test set in three sessions: the first session (S1) occurred before the educational intervention, the second session (S2) followed education without AI assistance, and the third session (S3) took place after education with AI assistance. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and overall performance, were compared between the sessions.
Results:
The mean sensitivity increased from 66.5% (95% confidence interval [CI], 59.2% to 73.7%) to 88.7% (95% CI, 84.1% to 93.3%), with a statistically significant difference (P<0.001), and the AUC non-significantly increased from 0.664 (95% CI, 0.606 to 0.723) to 0.684 (95% CI, 0.620 to 0.748) (P=0.300). Both measures were higher in S2 than in S1. The AI-achieved AUC was comparable to that of the expert reader (0.747 [95% CI, 0.640 to 0.855] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.217). Additionally, with AI assistance, the mean AUC for inexperienced readers was not significantly different from that of the expert reader (0.745 [95% CI, 0.660 to 0.830] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.120).
Conclusion
The mean AUC and sensitivity improved after incorporating AI into breast US education and interpretation. AI systems with high-level performance for breast US can potentially be used as educational tools in the interpretation of breast US images.
3.Improving breast ultrasonography education: the impact of AI-based decision support on the performance of non-specialist medical professionals
Sangwon LEE ; Hye Sun LEE ; Eunju LEE ; Won Hwa KIM ; Jaeil KIM ; Jung Hyun YOON
Ultrasonography 2025;44(2):124-133
Purpose:
This study evaluated the educational impact of an artificial intelligence (AI)–based decision support system for breast ultrasonography (US) on medical professionals not specialized in breast imaging.
Methods:
In this multi-case, multi-reader study, educational materials, including American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) descriptors, were provided alongside corresponding AI results during training. The AI system presented results in the form of AIheatmaps, AI scores, and AI-provided BI-RADS assessment categories. Forty-two readers evaluated the test set in three sessions: the first session (S1) occurred before the educational intervention, the second session (S2) followed education without AI assistance, and the third session (S3) took place after education with AI assistance. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and overall performance, were compared between the sessions.
Results:
The mean sensitivity increased from 66.5% (95% confidence interval [CI], 59.2% to 73.7%) to 88.7% (95% CI, 84.1% to 93.3%), with a statistically significant difference (P<0.001), and the AUC non-significantly increased from 0.664 (95% CI, 0.606 to 0.723) to 0.684 (95% CI, 0.620 to 0.748) (P=0.300). Both measures were higher in S2 than in S1. The AI-achieved AUC was comparable to that of the expert reader (0.747 [95% CI, 0.640 to 0.855] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.217). Additionally, with AI assistance, the mean AUC for inexperienced readers was not significantly different from that of the expert reader (0.745 [95% CI, 0.660 to 0.830] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.120).
Conclusion
The mean AUC and sensitivity improved after incorporating AI into breast US education and interpretation. AI systems with high-level performance for breast US can potentially be used as educational tools in the interpretation of breast US images.
4.Improving breast ultrasonography education: the impact of AI-based decision support on the performance of non-specialist medical professionals
Sangwon LEE ; Hye Sun LEE ; Eunju LEE ; Won Hwa KIM ; Jaeil KIM ; Jung Hyun YOON
Ultrasonography 2025;44(2):124-133
Purpose:
This study evaluated the educational impact of an artificial intelligence (AI)–based decision support system for breast ultrasonography (US) on medical professionals not specialized in breast imaging.
Methods:
In this multi-case, multi-reader study, educational materials, including American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) descriptors, were provided alongside corresponding AI results during training. The AI system presented results in the form of AIheatmaps, AI scores, and AI-provided BI-RADS assessment categories. Forty-two readers evaluated the test set in three sessions: the first session (S1) occurred before the educational intervention, the second session (S2) followed education without AI assistance, and the third session (S3) took place after education with AI assistance. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and overall performance, were compared between the sessions.
Results:
The mean sensitivity increased from 66.5% (95% confidence interval [CI], 59.2% to 73.7%) to 88.7% (95% CI, 84.1% to 93.3%), with a statistically significant difference (P<0.001), and the AUC non-significantly increased from 0.664 (95% CI, 0.606 to 0.723) to 0.684 (95% CI, 0.620 to 0.748) (P=0.300). Both measures were higher in S2 than in S1. The AI-achieved AUC was comparable to that of the expert reader (0.747 [95% CI, 0.640 to 0.855] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.217). Additionally, with AI assistance, the mean AUC for inexperienced readers was not significantly different from that of the expert reader (0.745 [95% CI, 0.660 to 0.830] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.120).
Conclusion
The mean AUC and sensitivity improved after incorporating AI into breast US education and interpretation. AI systems with high-level performance for breast US can potentially be used as educational tools in the interpretation of breast US images.
5.Improving breast ultrasonography education: the impact of AI-based decision support on the performance of non-specialist medical professionals
Sangwon LEE ; Hye Sun LEE ; Eunju LEE ; Won Hwa KIM ; Jaeil KIM ; Jung Hyun YOON
Ultrasonography 2025;44(2):124-133
Purpose:
This study evaluated the educational impact of an artificial intelligence (AI)–based decision support system for breast ultrasonography (US) on medical professionals not specialized in breast imaging.
Methods:
In this multi-case, multi-reader study, educational materials, including American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) descriptors, were provided alongside corresponding AI results during training. The AI system presented results in the form of AIheatmaps, AI scores, and AI-provided BI-RADS assessment categories. Forty-two readers evaluated the test set in three sessions: the first session (S1) occurred before the educational intervention, the second session (S2) followed education without AI assistance, and the third session (S3) took place after education with AI assistance. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and overall performance, were compared between the sessions.
Results:
The mean sensitivity increased from 66.5% (95% confidence interval [CI], 59.2% to 73.7%) to 88.7% (95% CI, 84.1% to 93.3%), with a statistically significant difference (P<0.001), and the AUC non-significantly increased from 0.664 (95% CI, 0.606 to 0.723) to 0.684 (95% CI, 0.620 to 0.748) (P=0.300). Both measures were higher in S2 than in S1. The AI-achieved AUC was comparable to that of the expert reader (0.747 [95% CI, 0.640 to 0.855] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.217). Additionally, with AI assistance, the mean AUC for inexperienced readers was not significantly different from that of the expert reader (0.745 [95% CI, 0.660 to 0.830] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.120).
Conclusion
The mean AUC and sensitivity improved after incorporating AI into breast US education and interpretation. AI systems with high-level performance for breast US can potentially be used as educational tools in the interpretation of breast US images.
6.Improving breast ultrasonography education: the impact of AI-based decision support on the performance of non-specialist medical professionals
Sangwon LEE ; Hye Sun LEE ; Eunju LEE ; Won Hwa KIM ; Jaeil KIM ; Jung Hyun YOON
Ultrasonography 2025;44(2):124-133
Purpose:
This study evaluated the educational impact of an artificial intelligence (AI)–based decision support system for breast ultrasonography (US) on medical professionals not specialized in breast imaging.
Methods:
In this multi-case, multi-reader study, educational materials, including American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) descriptors, were provided alongside corresponding AI results during training. The AI system presented results in the form of AIheatmaps, AI scores, and AI-provided BI-RADS assessment categories. Forty-two readers evaluated the test set in three sessions: the first session (S1) occurred before the educational intervention, the second session (S2) followed education without AI assistance, and the third session (S3) took place after education with AI assistance. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and overall performance, were compared between the sessions.
Results:
The mean sensitivity increased from 66.5% (95% confidence interval [CI], 59.2% to 73.7%) to 88.7% (95% CI, 84.1% to 93.3%), with a statistically significant difference (P<0.001), and the AUC non-significantly increased from 0.664 (95% CI, 0.606 to 0.723) to 0.684 (95% CI, 0.620 to 0.748) (P=0.300). Both measures were higher in S2 than in S1. The AI-achieved AUC was comparable to that of the expert reader (0.747 [95% CI, 0.640 to 0.855] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.217). Additionally, with AI assistance, the mean AUC for inexperienced readers was not significantly different from that of the expert reader (0.745 [95% CI, 0.660 to 0.830] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.120).
Conclusion
The mean AUC and sensitivity improved after incorporating AI into breast US education and interpretation. AI systems with high-level performance for breast US can potentially be used as educational tools in the interpretation of breast US images.
7.A study on the development of nutrition counseling manual and curriculum for the disabled in Korea: a mixed-methods study
Kyoung-Min LEE ; Woo-jeong KIM ; So-young KIM ; Young-mi PARK ; Hwa-young YOON ; Min-Sun JEON
Korean Journal of Community Nutrition 2025;30(5):376-388
Objectives:
Individuals with disabilities require targeted interventions to ameliorate disability-related conditions and improve overall health status. Nutritional challenges and counseling needs vary according to the type of disability, necessitating comprehensive assessments of dietary habits, physical activity, and food intake. Compared to traditional education, nutrition counseling offers a more sustainable and environmentally adaptable approach that effectively addresses individualized nutritional issues. Therefore, this study aimed to develop and evaluate a practical nutrition counseling manual and meal guidelines for people with disabilities in Korea, addressing their diverse dietary needs and improving nutritional care in social welfare facilities.
Methods:
A four-stage integrated research design was employed. Stage 1 involved qualitative research through in-depth interviews with 11 facility staff. In Stage 2, a nationwide survey (n = 249) was conducted based on the results of the interviews. Stage 3 integrated both qualitative and quantitative findings. Stage 4 focused on developing and evaluating a nutrition counseling manual and five types of meal guidelines through feedback from 26 nutritionists at 24 Korean Centers for Social Welfare Foodservice Management.
Results:
Six major nutrition counseling topics were identified: healthy eating, managing salt and sugar intake, dysphagia diet, appropriate intake, and hygiene. The manual and guidelines demonstrated high field usability, with average satisfaction scores of 3.98 and 3.99, respectively.
Conclusion
The integrated study resulted in the development of a specialized nutrition counseling manual and handbook for individuals with disabilities in Korean social welfare facilities. The materials were revised and improved based on practical evaluations by dietitians, enhancing their field applicability. These tools are expected to contribute to better dietary management and health promotion among facility residents. The developed materials reflect the real-world needs of people with disabilities and offer practical tools for effective nutrition counseling and dietary management in institutional settings.
8.Clinical Practice Guidelines for Diagnosis and Non-Surgical Treatment of Primary Frozen Shoulder
Byung Chan LEE ; Gi-Wook KIM ; Keewon KIM ; Nackhwan KIM ; Dong Hwan KIM ; Doo Young KIM ; Du Hwan KIM ; Beom Suk KIM ; Seong Hun KIM ; In Jong KIM ; Hyun Jung KIM ; Yoonju NA ; Kyung Eun NAM ; Sung Gyu MOON ; Chang-Won MOON ; Kyunghoon MIN ; Donghwi PARK ; Myung Woo PARK ; Yong Bok PARK ; Jae Hyeon PARK ; Chul-Hyun PARK ; Hyeng-Kyu PARK ; Yunsoo SOH ; Jaeki AHN ; Seoyon YANG ; Kyeong Eun UHM ; Sun Jae WON ; Yu Hui WON ; Dong Hwan YUN ; Yu Sung YOON ; Jin A YOON ; Byeong-Ju LEE ; Woo Hyung LEE ; Yun Jung LEE ; Jae-Hyun LEE ; Jong Hwa LEE ; Yu Jin IM ; Jae-Young LIM ; Min Cheol CHANG ; Sung Joon CHUNG ; Il Young JUNG ; Sungju JEE ; Kyoung Hyo CHOI ; Jong-Moon HWANG ; Jae-Young HAN
Clinical Pain 2025;24(1):1-26
Objective:
Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is made clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder.
Methods:
A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the Population, Intervention, Comparator, and Outcome (PICO) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework.
Results:
Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term functional disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and rather than as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilation with steroid injections can also be beneficial.
Conclusion
These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.
9.2025 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.
10.The Influence of Nursing Competency and Professional Self-concept of Outpatient Nurses Caring for Cancer Patients on Job Satisfaction
Young Hwa WON ; Hee Sun LEE ; Kyeom Bi KIM ; Jee Yoon KIM ; Jeong Hye KIM
Asian Oncology Nursing 2024;24(4):165-172
Purpose:
This study aimed to identify the relationship between nursing competency, professional self-concept, and job satisfaction of outpatient oncology nurses caring for cancer patients and to identify the influencing factors on job satisfaction.
Methods:
This study was a cross-sectional study to determine the relationship between nursing competency, professional self-concept, and job satisfaction of outpatient oncology nurses. Data were collected from 104 outpatient oncology nurses at a tertiary hospital in Seoul, South Korea, using a self-report questionnaire. Descriptive statistics, Pearson correlations, and multiple regression analyses were conducted using SPSSWIN 27.0.
Results:
The results showed that the nursing competency mean was 3.89±0.46 out of 5, professional self-concept mean was 2.84±0.36 out of 4, and job satisfaction mean was 3.88±0.57 out of 5. Job satisfaction was significantly positively correlated with nursing competency (r=.70, p<.001) and professional self-concept (r=.63, p<.001). Multiple regression analysis revealed that nursing competency (β=.51, p<.001) and professional self-concept (β= .31, p=.001) were significant predictors of job satisfaction and had an overall explanatory power of 54%.
Conclusion
In this study, professional self-concept and nursing competency were identified as influential factors in the job satisfaction of outpatient oncology nurses caring for cancer patients.Based on the findings of this study, it is necessary to develop a program to increase professional self-concept and enhance nursing competency to improve the job satisfaction of outpatient oncology nurses.

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