Dong Yeong Kim

Background: Frontier text-to-image models can synthesise radiologic images of high realism, raising the question of whether expert radiologists can serve as a provenance safeguard for the medical image record. Methods: We conducted a prospective, pre-registered visual Turing test in which 60 invited Korean board-certified radiology faculty and trainees judged authentic (teaching-repository) and AI-generated radiologic images from a locked pool of 241 displayable cells (82 entities; nine subspecialties; six modalities; 60 readers x 60 trials = 3,600 reader–image observations) produced by two contemporary commercial generators. The primary endpoint was the confidence-weighted, reader-averaged multi-reader multi-case area under the curve for AI versus authentic images, conditional on the locked image pool; the key secondary endpoint was the Faculty-minus-Junior difference under a two one-sided tests equivalence framework. The pre-specified statistical analysis plan was registered on the Open Science Framework before data lock. Findings: All 60 readers completed the test. The pooled confidence-weighted area under the curve was 0.71 (95% CI, 0.69 to 0.74), above the null value of 0.5 but within the pre-specified modest tier (0.60 to 0.75). The Faculty-minus-Junior contrast was 0.04 (95% CI, −0.02 to 0.10), including zero, and the two one-sided tests established equivalence within the +/−0.10 margin. No reader stratum and no pre-specified sensitivity analysis reached the deployable-classifier threshold (area under the curve >= 0.75). Interpretation: In this single-country cohort, expert radiologists distinguished frontier-generated from authentic radiologic images only modestly, without a meaningful expertise gradient (equivalence within +/−0.10) and with no reader stratum reaching a standalone provenance safeguard. These findings support radiology AI-literacy training and pipeline-level provenance safeguards rather than reliance on reader judgment, and warrant retesting in an independent reader cohort. Funding: This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: RS-2025-02213531).

Nam Y, et al. Korean J Radiol. 2025 Aug;26:e68. https://doi.org/10.3348/kjr.2025.0599

Kim DY, et al. Korean J Radiol. 2023 Dec;24(12):1179-1189. https://doi.org/10.3348/kjr.2023.1027

Song SW, et al. J Korean Med Sci. 2020 Oct;36(2):e14. https://doi.org/10.3346/jkms.2021.36.e14

Kim PH, et al. Korean J Radiol. 2020 Jul;21:e181. https://doi.org/10.3348/kjr.2020.0728

This study aimed to evaluate the radiologic response and adverse event rates of immune checkpoint inhibitor (ICI) therapy with or without radiotherapy for the treatment of non-small cell lung cancer (NSCLC) brain metastases. A systematic literature search was performed up to January 3, 2020. Studies evaluating the intracranial objective response rates (ORR) and/or disease control rates (DCR) of ICI with or without radiotherapy for treating NSCLC brain metastases were included. Consequently, twelve studies satisfied inclusion criteria. ICI combined with radiotherapy (pooled ORR, 95%; DCR, 97%) showed better local efficacy compared to ICI monotherapy (pooled ORR, 24%; DCR, 44%; p < 0.01 for both ORR and DCR). Grade 3 or 4 central nervous system (CNS)-related adverse event rates were not different (5% vs. 4%; p = 0.93). In conclusion, ICI combined with radiotherapy showed better intracranial efficacy than ICI monotherapy for treating NSCLC brain metastases. CNS-related grade 3 or 4 adverse event rate was not statistically different between the two groups. Several prospective trials are needed to compare the efficacy of ICI combined with radiotherapy and ICI monotherapy.

Background: Cetuximab has shown clinical benefit in patients with metastatic colorectal cancer (mCRC) harbouring wild-type RAS. HER2 amplification has been suggested as one of the resistant mechanisms of cetuximab treatment. We evaluated association between HER2 amplification and cetuximab efficacy in mCRC patients harbouring extended RAS wild-type.