The anticancer drugs have evolved significantly, spanning molecular targeted therapeutics (MTTs), immune checkpoint inhibitors (ICIs), chimeric antigen receptor T-cell (CAR-T) therapy, and antibody-drug conjugates (ADCs). Complications associated with these drugs vary widely based on their mechanisms of action. MTTs that target angiogenesis can often lead to complications related to ischemia or endothelial damage across various organs, whereas non-anti-angiogenic MTTs present unique complications derived from their specific pharmacological actions. ICIs are predominantly associated with immunerelated adverse events, such as pneumonitis, colitis, hepatitis, thyroid disorders, hypophysitis, and sarcoid-like reactions. CAR-T therapy causes unique and severe complications including cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. ADCs tend to cause complications associated with cytotoxic payloads. A comprehensive understanding of these drug-specific toxicities, particularly using medical imaging, is essential for providing optimal patient care. Based on this knowledge, radiologists can play a pivotal role in multidisciplinary teams. Therefore, radiologists must stay up-to-date on the imaging characteristics of these complications and the mechanisms underlying novel anticancer drugs.

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.

Clinical trials for chimeric antigen receptor (CAR) T-cell therapy are in the early stages but are expected to progress alongside new treatment approaches. This suggests that imaging will play an important role in monitoring disease progression, treatment response, and treatment-related side effects. There are, however, challenges that remain unresolved, regarding imaging in CAR T-cell therapy. We herein discuss the role of imaging, focusing on how tumor response evaluation varies according to cancer type and target antigens in CAR T-cell therapy. CAR T-cell therapy often produces rapid and significant responses, and imaging is vital for identifying side effects such as cytokine release syndrome and neurotoxicity. Radiologists should be aware of drug mechanisms, response assessments, and associated toxicities to effectively support these therapies. Additionally, this article highlights the importance of the Lugano criteria, which is essential for standardized assessment of treatment response, particularly in lymphoma therapies, and also explores other factors influencing imaging-based evaluation, including emerging methodologies and their potential to improve the accuracy and consistency of response assessments.

Endometriosis, a prevalent but debilitating condition affecting women, poses significant challenges in diagnosis and management. The current 2024 guideline, developed by the Korean Society of Endometriosis (KSE), builds upon the 2018 KSE guideline. This guideline aims to provide customized recommendations tailored to Korea’s unique clinical aspects and medical environment, and addresses key areas such as diagnosis, medical and surgical management, considerations for special populations, and its complex relationship with cancer.

Objective: To analyze the microbiological and clinical characteristics of vulvovaginitis in girls, distinguishing between the premenarcheal and postmenarcheal groups in a tertiary center in South Korea. Methods: This retrospective cohort study included 195 patients under 20 years of age diagnosed with vulvovaginitis at a tertiary hospital between 2014 and 2023. The patients were categorized into premenarcheal (n=95) and postmenarcheal (n=100) groups. Data on initial symptoms, microbial cultures, and treatment methods were analyzed. Results: The most common initial symptom was vaginal discharge, reported in 63.1% of cases. Culture results showed a 51.3% positivity rate for any microorganism, with a prevalence of gram-negative rods (32.8%) and gram-positive cocci (14.4%). The most frequently isolated microorganisms were Escherichia coli (17.9%), Candida albicans (7.7%), and Enterococcus faecalis (6.7%). Gram-negative rods were more common in the premenarcheal group (37.1% vs. 25.0%; p=0.01). No significant differences were observed in the prevalence of gram-positive cocci and Candida species between the two groups (16.8% vs. 12.0%, p=0.22; 6.3% vs. 13.0%, p=0.09; respectively). The susceptibilities of grampositive microorganisms to penicillin, oxacillin, clindamycin, vancomycin, and tetracycline were 58.8%, 58.3%, 94.7%, 100.0%, and 73.7%, respectively. The susceptibilities of gram-negative microorganisms to amoxicillin/clavulanic acid, ciprofloxacin, ceftriaxone, and nitrofurantoin were 89.3%, 85.3%, 76.0%, and 100.0%, respectively. Conclusion This study identified differences in the microbial profiles associated with vulvovaginitis between premenarcheal and postmenarcheal girls. Age-specific and history-based clinical approaches tailored to menarcheal status are warranted to improve the management and outcomes of pediatric and adolescent vulvovaginitis.

Molecular diagnostics are essential for detecting intestinal parasites, but evaluating clinical samples from low endemic areas, including Korea, is challenging. We tested the performance of the BD MAX Enteric Parasite Panel in simulated samples for clinical use. Simulated samples were prepared with residual stool samples to confirm the diagnostic performance of the kits. Standard materials for Cryptosporidium parvum, Giardia lamblia, and Entamoeba histolytica were obtained for assessment. Limit of detection was determined by diluting standard materials into multiple concentrations and testing each in duplicate. Repeatability was assessed by retesting all samples twice. Accuracy was evaluated by comparing BD MAX System results with intended results. The limit of detection values obtained using standard materials were 781 cysts/ml, 6,250 oocysts/ml, and 125 DNA copies/ml for G. lamblia, C. parvum, and E. histolytica, respectively. Simulated G. lamblia-positive stool samples with concentrations above 6,250 cysts/ml consistently yielded positive results (100% concordance). However, C. parvum-positive stool samples at 6,250 oocysts/ml showed 50% concordance initially and 75% after retesting. At 62,500 oocysts/ml, the concordance rates were 89% initially and 100% after retesting. Overall agreement was 95.2%, but that for C. parvum was relatively low (82.4%). The diagnostic performances were 87.8% of sensitivity and 100% of specificity. Despite the limited clinical samples, BD MAX Enteric Parasite Panel showed good performance for clinical use, and spiked samples proved useful for evaluating protozoan PCR in low-incidence regions.

Objective: In South Korea, there is a significant gap in systematic, evidence-based research on intensive case management (ICM) for individuals with severe mental illness (SMI). This study aims to evaluate the effectiveness of ICM through a randomized controlled trial (RCT) comparing ICM with standard case management (non-ICM). Methods: An RCT was conducted to assess the effectiveness of Seoul-intensive case management (S-ICM) vs. non-ICM in individuals with SMI in Seoul. A total of 78 participants were randomly assigned to either the S-ICM group (n=41) or the control group (n=37). Various clinical assessments, including the Brief Psychiatric Rating Scale (BPRS), Montgomery–Åsberg Depression Rating Scale, Health of the Nation Outcome Scale, and Clinical Global Impression-Improvement (CGI-I), along with quality-of-life measures such as the WHO Disability Assessment Schedule, WHO Quality of Life scale, and Multidimensional Scale of Perceived Social Support (MSPSS) were evaluated over a 3-month period. Statistical analyses, including analysis of covariance and logistic regression, were used to determine the effectiveness of S-ICM. Results: The S-ICM group had significantly lower odds of self-harm or suicidal attempts compared to the control group (adjusted odds ratio [aOR]=0.30, 95% confidence interval [CI]: 0.21–1.38). Psychiatric symptoms measured by the BPRS and perceived social support measured by the MSPSS significantly improved in the S-ICM group. The S-ICM group also had significantly higher odds of CGI-I compared to the control group (aOR=8.20, 95% CI: 2.66–25.32). Conclusion This study provides inaugural evidence on the effectiveness of S-ICM services, supporting their standardization and potential nationwide expansion.

Gastric cancer is the fourth most common malignancy in Korea and remains the fifth and seventh leading cause of cancer death in males and females, respectively. Although the survival rates for gastric cancer have improved, unresectable or metastatic gastric cancer still has an abysmal prognosis, and the five-year survival rate for patients with stage IV gastric cancer is approximately 6.6% in Korea. The treatment of patients with unresectable or metastatic gastric cancer is based on chemotherapy. A combination of fluoropyrimidine and platinum is the most widely used first-line treatment for gastric cancer worldwide. In recent decades, a better understanding of cancer biology has led to targeted therapies becoming the treatment paradigm for many cancers, including gastric cancer.In addition, immunotherapies have also been reported to improve survival in several cancers, particularly in patients with unresectable or metastatic gastric cancer who have failed multiple lines of chemotherapy. This review evaluates landmark studies on chemotherapy for unresectable or metastatic gastric cancer, including targeted therapies and immunotherapies.

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that mainly occur in the stomach and small intestine; those arising in the esophagus are rarer. A 54-year-old woman was referred to our hospital with a one-month history of dysphagia. Esophagogastroduodenoscopy (EGD), performed approximately five months earlier, had not revealed any specific findings. However, an EGD performed in our hospital showed the presence of a round, protruding lesion (approximately 40×30 mm in size), with a normal overlying mucosal surface, 35–39 cm from the upper incisor. Chest computed tomography (CT) revealed a large esophageal mass. Enucleation was performed on the esophageal mass, and a GIST was diagnosed using immunochemical staining. Imatinib mesylate administration was initiated two months postoperatively. The patient was stable, without any evident recurrence in the 8-month postoperative follow-up EGD and chest CT examinations. Therefore, physicians should consider that patients with worsening dysphagia may have an underlying organic condition, such as an acute increase in size of an esophageal GIST, even if recent examinations were unremarkable.