Objectives: To assess the trends and disparities in the utilization of F-18 fluorodeoxyglucose positron emission tomography/ computed tomography (FDG PET/CT) in Korea between 2018 and 2022, with a focus on disease classification, patient demographics, and regional distribution. Methods: This national surveillance retrospective study uses data from the Health Insurance Review and Assessment Service (HIRA) database, which includes all FDG PET/CT examinations conducted in Korea from 2018 to 2022. Disease classifications, cancer types, age groups, gender, and geographic regions were analyzed using descriptive statistics. Utilization rates per 100,000 population were calculated for regional comparisons. Results: FDG PET/CT utilization increased by 25.4%, from 174,885 examinations in 2018 to 219,377 in 2022. Older age groups (60 years and above) accounted for the majority of examinations, with males undergoing more examinations than females. Oncology remained the primary indication, with lung, colorectal, and non-Hodgkin lymphoma leading in examination numbers. The number of examinations performed on patients aged 60 and above increased at a higher rate compared to those under 60. Significant geographic disparities were found, with Seoul reporting the highest utilization rate (1,114.3 examinations per 100,000 population), while Gyeongbuk exhibited much lower rate (26.2 examinations per 100,000 population). Conclusions This study highlights the growing utilization of FDG PET/CT in Korea, particularly among older adults, with significant gender differences in cancer types. The findings also reveal disparities in FDG PET/CT utilization across regions, indicating varying access to advanced imaging technology.

Objectives: To assess the trends and disparities in the utilization of F-18 fluorodeoxyglucose positron emission tomography/ computed tomography (FDG PET/CT) in Korea between 2018 and 2022, with a focus on disease classification, patient demographics, and regional distribution. Methods: This national surveillance retrospective study uses data from the Health Insurance Review and Assessment Service (HIRA) database, which includes all FDG PET/CT examinations conducted in Korea from 2018 to 2022. Disease classifications, cancer types, age groups, gender, and geographic regions were analyzed using descriptive statistics. Utilization rates per 100,000 population were calculated for regional comparisons. Results: FDG PET/CT utilization increased by 25.4%, from 174,885 examinations in 2018 to 219,377 in 2022. Older age groups (60 years and above) accounted for the majority of examinations, with males undergoing more examinations than females. Oncology remained the primary indication, with lung, colorectal, and non-Hodgkin lymphoma leading in examination numbers. The number of examinations performed on patients aged 60 and above increased at a higher rate compared to those under 60. Significant geographic disparities were found, with Seoul reporting the highest utilization rate (1,114.3 examinations per 100,000 population), while Gyeongbuk exhibited much lower rate (26.2 examinations per 100,000 population). Conclusions This study highlights the growing utilization of FDG PET/CT in Korea, particularly among older adults, with significant gender differences in cancer types. The findings also reveal disparities in FDG PET/CT utilization across regions, indicating varying access to advanced imaging technology.

Background: Adiposity rebound (AR) refers to the period during growth when the body mass index reaches its lowest point before increasing again. The timing of AR is associated with the development of obesity and puberty onset. Although studies have evaluated AR timing in Korean children, none has focused on children born small for gestational age (SGA). Methods: This study analyzed data from a multicenter observational clinical trial (LG Growth Study) to determine AR timing in children born SGA without catch-up growth (CUG) who were treated with growth hormone (GH) therapy. The study also aimed to identify factors associated with AR timing, examine the influence of AR timing on puberty onset, and assess the effectiveness of GH therapy. Results: A total of 151 children born SGA without CUG were included. Of them, 15% experienced AR between 4 and 5 years of age, 42% between 5 and 6 years, 27% between 6 and 7 years, and 16% after 7 years of age. A significant positive correlation was noted between the height standard deviation score at the start of treatment and AR timing. However, no significant correlation was observed between AR timing and puberty onset or the effectiveness of GH therapy. Conclusion This study provides insights into AR timing in prepubertal children who meet the specific SGA criteria and its relationship with growth outcomes. The findings suggest that AR in children born SGA who do not experience CUG occurs later than in the general population, with no significant relationship between AR timing and puberty onset or growth outcomes.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.

Background/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score. Methods: We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score. Results: A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites. Conclusions The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.

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.

Background/Aims: Although the urea breath test (UBT) is widely used as a representative monitoring test after Helicobacter pylori eradication, false-negative results can occur because of the gray zone related to its cutoff value. This study aimed to compare the diagnostic performances of the rapid urease test (RUT), the RUT with sweeping method, and the UBT, and to investigate the role of the sweeping method in the gray zone of UBT values. Methods: We retrospectively reviewed 216 patients who received standard first-line H. pylori eradication treatments (n=216). All participants underwent to testing using the sweeping method and UBT on the same day. The sensitivity, specificity, and accuracy were analyzed to compare the two methods. Results: The sensitivity (0.537 vs 0.806, p=0.002) and accuracy (0.843 vs 0.870, p=0.026) of the UBT were inferior to those of the sweeping method. A total of 31 individuals tested positive for H. pylori according to the UBT, whereas 54 individuals tested positive according to the sweeping method. In the group for which the gold standard definition indicated H. pylori positivity but UBT results were negative (n=31), all individuals had a UBT value under 2.5‰. In the multivariate logistic regression model, a UBT value of 1.4‰ to 2.5‰ increased the risk of false-negative results by 6.5 times (odds ratio, 6.5; 95% confidence interval, 2.077 to 20.288; p=0.001). Conclusions After H. pylori eradication, false-negative results can occur for individuals undergoing the UBT, primarily for values below the UBT cutoff. The RUT with the sweeping method can potentially help detect H. pylori in the gray zone of the UBT, improving diagnostic accuracy.

Purpose: Pancreatic cancer has a poor prognosis; however, the implementation of neoadjuvant treatment enables borderline resectable cases to undergo curative resection and improves the overall survival rate. Attempts have been made to expand the eligibility criteria for neoadjuvant treatment, even in resectable cases. Some studies have suggested a correlation between vein abutment and poor prognosis or that the abutment angle may affect prognosis. This study investigated the anatomical factors affecting the vessel abutment angle and its prognostic value in pancreatic cancer. Methods: Patients with pancreatic ductal adenocarcinoma who underwent surgery between 2012 and 2017 were included in this study. Patients who underwent neoadjuvant treatment were excluded. Data from only the intent-to-treat pancreaticoduodenectomy group were included in the analysis. Clinicopathological characteristics; preoperative factors such as CA 19-9, preoperative biliary drainage, American Society of Anesthesiologists physical status classification, portal vein/superior mesenteric vein contact angle measured via CT scan; and intraoperative factors were collected for analysis. Results: A total of 365 patients were included in this study, and the abutment group included 92 patients (25.2%). The abutment and no-contact groups did not show any significant differences in terms of the overall survival or diseasefree survival rate. Among the abutment groups, patients with less than 90° and 90°–180° did not show any significant differences. In the multivariate analysis, the only preoperative factor that had a prognostic effect was CA 19-9, a biological factor. Conclusion When there is no vessel invasion in the abutment group, upfront surgery should be considered because the angle does not affect the overall prognosis.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.