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. 2025 Jun 17;26(7):638–649. doi: 10.3348/kjr.2025.0118

Foreign Body Ingestion: Radiologic Evaluation, Findings, and Management

Sang Min Lee 1, Song-Ee Baek 2, Choong Wook Lee 3, Young Chul Kim 4, Min-Jeong Kim 5,✉
PMCID: PMC12235546  PMID: 40590076

Abstract

Foreign body ingestion and sensation are common clinical conditions encountered in emergency and outpatient settings. True foreign body ingestion typically involves a history of swallowing a foreign object and is often confirmed by radiographic findings. The management of foreign body ingestion depends on the type, size, and location of the object, as well as the patient’s symptoms. High-risk objects, such as button/disk batteries, multiple magnets, and sharp objects, often require urgent or emergent endoscopic removal to prevent severe complications such as perforation, obstruction, and fistula formation. Imaging is crucial for diagnosis and management, with radiographs being the first-line modality and CT offering superior sensitivity for detecting radiolucent objects and complications. Mimickers of foreign body ingestion and sensations, even without the presence of an actual foreign body, arise from motility disorders (e.g., achalasia), structural or mucosal abnormalities (e.g., Zenker’s diverticulum, reflux esophagitis, and esophageal strictures), and extrinsic compression. Although these mimickers produce similar symptoms, they require different diagnostic approaches. This review highlights the radiological findings, management strategies for various foreign bodies, and the distinguishing features of their mimickers, emphasizing the importance of timely and accurate differentiation to guide appropriate interventions and improve patient outcomes.

Keywords: Foreign body, Ingestion, Mimickers, Sensation, Imaging

INTRODUCTION

Foreign body ingestion is a frequent cause of emergency room visits, and patients often present with the sensation of a foreign body. True foreign body ingestion is typically characterized by a history of swallowing an object, as confirmed by radiographic imaging, and commonly presents with acute symptoms such as dysphagia. By contrast, foreign body sensations without ingestion tend to result in chronic symptoms and are generally managed in outpatient settings. However, chronic symptoms may arise from ingestion of foreign bodies embedded in the gastrointestinal (GI) tract, leading to granuloma formation. Radiological findings play an essential role in distinguishing true foreign body ingestion from other conditions, thereby guiding appropriate diagnosis and treatment. This review focuses on the radiological evaluation and management of foreign body ingestion. It also briefly describes the conditions that mimic a foreign body sensation.

Brief Epidemiology

Foreign body ingestion can occur at any age; however, it is most common in pediatric populations [1]. It is the leading cause of mortality from unintentional injuries among children under one year of age. In adults, foreign body ingestion occurs in patients with preexisting pathologies, such as esophageal stricture or cancer [2]. It occurs more frequently in older adults, patients with psychiatric disorders or mental retardation, or those in prison for secondary gain [1,3]. Approximately 10% of adult cases involve the intentional ingestion of foreign bodies [4].

Patients with foreign body ingestion may present with various symptoms including dysphagia, odynophagia, foreign body sensation, chest or abdominal pain, and vomiting [1,3]; however, some patients remain asymptomatic [4]. Patients with poor communication skills, such as children and those with mental health problems, may present with hypersalivation, refusal to eat, and irritability. Occasionally, aspiration of saliva or tracheal compression by a foreign body can result in respiratory symptoms such as choking, stridor, or dyspnea [1]. Complications associated with foreign body ingestion include bowel perforation [5] and obstruction, fistula formation, and sepsis. More severe complications include perforation of the pharynx or esophagus, which is associated with high mortality.

A large-scale, single-center study in China [2] showed that the type of foreign body ingested varied depending on the patient’s age. While coins are the most commonly ingested foreign body in children under 14 years of age, fish bones and dental prosthetics or food boluses are most common among individuals aged 15–59 years and those over 60 years, respectively. Further, a multicenter study in Korea [6] investigating 424 pediatric endoscopic foreign body removal procedures found that coins (45.3%) were the most commonly ingested foreign bodies, followed by button/disk batteries (17.2%), marble stones (6.6%), and magnets (6.1%).

Evaluation of Foreign Body Ingestion: Role of Imaging Modalities

Imaging modalities enable the diagnosis of foreign body ingestion and, consequently, guide clinical management. Radiography is the recommended first-line imaging modality for the detection of foreign body ingestion. Bidirectional neck, chest, and abdominal radiographs can be obtained based on the clinical findings [3,7]. Radiographs can effectively identify the type, size, and location of swallowed objects, particularly radiopaque (in this article, the terms ‘radiopaque’ and ‘radiolucent’ refer to plain radiography features) objects (Table 1) [7]. However, radiographs are less effective for the initial evaluation of non-radiopaque ingested foreign bodies [8], including food boluses, fish bones, glass fragments, plastic materials, and wooden items [1]. Serial imaging of radiographs enables tracking of the movement of radiopaque foreign bodies (Fig. 1) [7]. Radiography also facilitates the detection of complications due to foreign objects, including pneumomediastinum and pneumoperitoneum, which are indicative of pharyngeal and upper GI tract perforations, respectively. Additionally, lateral neck radiographs play an important role in determining the widening of the prevertebral soft tissue, suggestive of edema or inflammation, possibly caused by foreign body impaction and perforation of the pyriform sinuses and cervical esophagus [7].

Table 1. Representative examples of radiopaque and radiolucent foreign objects.

Opacity of the objects* Examples
Radiopaque objects (usually delineated on radiographs) Batteries, magnets, coins, pins, dental prosthesis, scissors, blade, and wire
Radiolucent objects (rarely delineated on radiographs) Food bolus, fish or chicken bones, wood, plastic, glass, and thin metal objects
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*‘Radiopaque’ vs. ‘radiolucent’ refers to plain radiography features

Fig. 1. A 22-year-old woman with a swallowed hairpin that was traceable by serial radiographs. A, B: A radiograph (A) showed a hairpin located in the left upper quadrant of the abdomen, which was subsequently identified within a small bowel loop on non-contrast CT (B). C: A radiograph obtained two days later revealed migration of the hairpin to the lower right abdomen. D: The foreign body was successfully retrieved from the ascending colon during colonoscopy.

Fig. 1

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CT, often considered to be a secondary imaging modality, offers greater sensitivity for identifying foreign objects, particularly radiolucent objects (Fig. 2) [9]. Visualization of foreign objects depends on the opacity of the objects and density of the surrounding tissues [7]. Three-dimensional reformations also enhance foreign body visualization [10]. CT enables the evaluation of complications, preprocedural planning, and direct visualization of foreign bodies [7]. CT can show findings related to bowel perforation owing to foreign body ingestion, including thickened wall, stranding in adjacent soft tissues, and the presence of air outside the lumen, while also allowing for direct visualization of foreign bodies within an abscess (Fig. 3) [7,11].

Fig. 2. A 67-year-old man complaining of foreign body sensation after eating chicken. A, B: A chest radiograph (A) showed no abnormal radiopaque foreign bodies. However, the coronal contrast-enhanced CT image (B) revealed a chicken bone (arrow) lodged in the esophagus.

Fig. 2

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Fig. 3. A 49-year-old man with fever complained of a foreign body sensation after swallowing a denture. A, B: Antero-posterior (A) and lateral (B) neck radiographs revealed a denture with sharp margins posterior to the trachea. Note the prevertebral widening and emphysema (arrow) in the lateral view of the neck. C, D: Axial (C) and coronal (D) contrast-enhanced CT images of the neck showed the denture impacted in the hypopharynx, accompanied by an abscess resulting from perforation of the left pyriform sinus (arrows).

Fig. 3

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Management of Foreign Body Ingestion

Most foreign objects naturally exit the GI tract without the need for intervention. Nevertheless, approximately 10%–20% of foreign body ingestion cases necessitate endoscopic extraction, whereas surgical removal is essential in only 1% of cases [9]. Several organizations, including the European Society of Gastrointestinal Endoscopy (ESGE), American Society for Gastrointestinal Endoscopy (ASGE), and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN), have suggested clinical guidelines for managing foreign body ingestion [1,9,12]. The approach used depends on the type, size, location, and duration of foreign body ingestion. Additionally, patient age and symptoms, such as dysphagia, pain, or signs of perforation, should also be considered. Endoscopic interventions for ingested objects are classified into three timing categories based on the risk of complications: emergent (within 2 hours), urgent (within 24 hours), and non-urgent (within 72 hours) [1].

Common high-risk objects, including button/disk batteries, magnets, and sharp objects, often warrant emergent endoscopic removal (<2 hours), particularly in cases of complete obstruction, sharp objects in the esophagus, or button/disk batteries in the esophagus [1,9]. Urgent endoscopic removal (<24 hours) is required for sharp objects in the stomach or duodenum, and multiple magnets or long objects in the stomach [1,9,12]. Furthermore, non-urgent endoscopic removal (<72 hours) is warranted in asymptomatic cases of non-threatening objects entering the small bowel [1]. Table 2 summarizes the timing of the endoscopic intervention for foreign body ingestion [1,9,12].

Table 2. Timing of endoscopic intervention for foreign body ingestion according to ESGE guideline, ASGE guideline, and NASPGHAN guideline.

Object type Location Timing*
Any object Esophagus with obstruction symptoms Emergent
Button/disk battery Esophagus Emergent
Stomach/small bowel Urgent
Coin Esophagus Non-urgent
Stomach/small bowel Non-urgent†
Magnet Esophagus Urgent
Stomach/small bowel Urgent
Sharp object Esophagus Emergent‡
Stomach/small bowel Urgent
Long object (>6 cm)§ Esophagus Urgent
Stomach/small bowel Urgent
Wide object (>2.5 cm)∥ Esophagus Urgent
Stomach/small bowel Non-urgent
Food bolus Esophagus Urgent
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*Emergent, urgent, and non-urgent require interventions within 2, 24, and 72 hours, respectively, †According to NASPGHAN guideline, removal of coin in the stomach can be delayed up to 2–4 weeks in an asymptomatic patients, ‡According to NASPGHAN guideline, a sharp object in esophagus without symptoms requires urgent endoscopic removal, §According to the ESGE guideline, a long object is defined as >5–6 cm, whereas other guidelines define it as >6 cm, ∥According to the ESGE guideline, a wide object is defined as >2–2.5 cm, while other guidelines use >2.5 cm as the threshold.

ESGE = European Society of Gastrointestinal Endoscopy, ASGE = American Society for Gastrointestinal Endoscopy, NASPGHAN = North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

Specific Foreign Bodies

Button/Disk Batteries

Button (also referred to as disk) batteries are commonly used in various portable electronics such as watches, hearing aids, remote controls, calculators, toys, and medical devices. The incidence of battery ingestion has increased, making it a common form of foreign body ingestion in the pediatric population [13,14].

Button batteries leak alkaline solutions and cause rapid liquefaction necrosis owing to corrosion, resulting in esophageal mucosal damage [7]. Larger button batteries (≥20 mm) are more likely to become lodged in the esophagus, resulting in severe outcomes [13,15]. Serious complications, including bowel perforation and tracheoesophageal fistula formation, have been confirmed in some cases [16]; these cases require emergent endoscopic retrieval (<2 hours) [1,9]. Particularly, aortoesophageal fistulas can be fatal [17]; therefore, NASPGHAN guidelines recommend CT angiography or MRI when esophageal mucosal injury is suspected following button battery removal [12]. These recommendations are supported by reports of aortoesophageal fistulas caused by button battery ingestion that have been confirmed by CT angiography, leading to appropriate and timely treatment and patient survival [18,19].

Button batteries are typically confused with coins during imaging. Therefore, differential diagnosis is important because the ingestions of these two objects are managed in different ways. Button batteries appear as “halo” or double rim signs on frontal radiographs (Figs. 4, 5) [20]. In ambiguous cases, additional lateral projection can help identify the “step-off sign,” which is another pathognomonic for button batteries [20].

Fig. 4. Differential imaging features of button/disk batteries and coins. A, B: Frontal and lateral radiographic images of a button/disk battery (A) showing the halo and step-off signs. In contrast, the radiographic images of the coin (B) did not show a halo or step-off sign.

Fig. 4

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Fig. 5. A 3-year-old child presenting with irritability and worsening cough. A: A chest radiograph showed a round object with peripheral halo indicating a “halo sign” or “double rim sign” lodged at the level of the cervical esophagus. B: Endoscopy revealed a disk-shaped button battery with a whitish exudate in the cervical esophagus. C: It was removed endoscopically. D: Endoscopy after removal showed mucosal erosion with necrotic foci. E: A coronal contrast-enhanced CT image obtained after removal of the button battery showed suspicious extraluminal air densities around the esophagus and extensive mediastinal edema abutting the trachea and left carotid artery (*) arising from the aortic arch (aa). No definite tracheoesophageal or aortoesophageal fistulae were observed. F: Esophagography showed bilateral diverticula (arrowheads) at the level of the previously impacted button battery without contrast leakage.

Fig. 5

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Once in the stomach, most button batteries spontaneously pass through the GI tract [9]. However, button batteries arrested in small bowel can cause mucosal damage and complications. Therefore, button batteries below the esophagus should be monitored using radiographs every 3–4 days. Furthermore, surgery should be considered if button batteries are suspected to be lodged in the small bowel [9,15].

According to a retrospective study analyzing 2382 ingestions of cylindrical and button batteries, cylindrical batteries were associated with a lower incidence of ingestion and lower rates of major complications than button batteries. Nevertheless, cylindrical batteries should be removed endoscopically when they are arrested in the stomach for more than 48 hours (Fig. 6) [9].

Fig. 6. A 27-year-old prisoner with mild abdominal pain. A: An abdomen radiograph revealed two cylindrical batteries (arrow) in the mid-abdomen without evidence of perforation or obstruction. B, C: Endoscopy (B) showed two AA-type cylindrical batteries in the stomach, which were subsequently removed (C). D: Post-removal endoscopy revealed erosion and a whitish membrane, suggesting a corrosive injury.

Fig. 6

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Coins

Coins are one of the most common foreign bodies ingested by young children (Fig. 7) [9]. When asymptomatic, coins lodged in the esophagus and stomach can be monitored for 12–24 hours and up to 2–4 weeks, respectively, before proceeding to non-urgent endoscopic retrieval [9,12,21]. Most coins traverse the GI tract without causing an obstruction. However, emergent intervention is required for the presentation of marked symptoms, such as hypersalivation and stridor [9].

Fig. 7. A 6-year-old boy who swallowed a 100-won coin. A: An abdominal radiograph revealed a round opacity in the mid-abdomen. B: Subsequent endoscopy revealed a coin in the stomach, which was retrieved endoscopically. C: A photograph confirmed that the object was a 100-won coin.

Fig. 7

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Magnets

Magnets, which are commonly found in children’s toys, pose significant risks as foreign objects and require urgent endoscopic removal. The ingestion of multiple magnets can cause entrapment of the bowel between them, potentially leading to necrosis [7]. Severe complications associated with multiple magnets, such as bowel necrosis, perforation, and fistula formation (Fig. 8), necessitate the accurate determination of the number of ingested magnets [9,19]. In some cases, additional lateral imaging may assist in identifying multiple magnets [22].

Fig. 8. A 16-month-old child with massive hematochezia. A: An abdominal radiograph showed seven small magnetic beads aligned in a row at the L1-3 level. B, C: Although the evaluation was limited by streak artifacts, axial (B) and sagittal (C) CT images revealed multiple magnetic beads in a row with anteroposterior projections from the stomach (S) to the proximal jejunum (J). D: An intraoperative photograph shows magnetic beads penetrating the colonic mesentery.

Fig. 8

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According to the NASPGHAN guidelines, management strategies differ based on the number of magnets ingested [12]. Any magnet located in the esophagus or stomach should be urgently removed via endoscopy, even if only a single magnet is present. Surgical intervention is warranted for symptomatic ingestion of multiple magnets beyond the stomach. Conversely, if the single magnet is not removable with endoscopy, a conservative approach involving observation and follow-up with serial imaging is recommended, alongside education on avoiding exposure to external magnets and metals, as magnetic attraction to them through body tissues can cause injury to the tissue caught in between.

Sharp Objects

Sharp objects present a higher risk of perforation than blunt objects. When ingestion of sharp objects is suspected, their location should be determined [9]. Sharp objects lodged in the esophagus require emergent endoscopic removal [1,9]. For objects located in the stomach or duodenum, urgent endoscopic removal should be performed due to the high complication rate (35%) [1]. Sharp objects beyond the duodenum should be monitored daily with radiographs, and surgery should be considered if no progression is observed radiographically for three consecutive days [9,23].

Sharp objects include toothpicks, fish and chicken bones, drug packages, and dental prostheses. As most of these objects are nonradiopaque, they are usually invisible on radiographs. CT imaging is recommended when objects are difficult to detect on radiographs and complications are suspected (Fig. 2) [24].

Toothpicks are made of plastic or wood, and ingestion rarely occurs; however, they cause severe complications, including penetration of the liver, abdominal vessels, and kidneys [25]. Fish bones are the most common accidentally ingested foreign bodies among patients in South Korea [11,26]. However, most of them spontaneously exit the GI tract without any symptoms [27,28]. They are lodged in the oral cavity or pharynx, particularly within the tonsils or at the base of the tongue, and can be removed using a scope. Complications are rare (<1% of cases); nevertheless, fish bones are among the most common foreign bodies perforating the bowel, requiring surgery [11,29,30]. Like most sharp objects, they are typically non-radiopaque and are therefore usually invisible on radiography. However, CT is a highly sensitive method for detecting fish bones (Fig. 9) [27].

Fig. 9. A 62-year-old man complaining of foreign body sensation after eating rockfish. A: A lateral neck radiograph revealed a linear hyperdense fish bone (arrow) in the prevertebral space. B: An abdominal radiograph showed a subtle hyperdense fish bone (arrow) in the mid-abdomen, although it is not clearly visible. C: In contrast, a coronal contrast-enhanced CT image distinctly displayed a hyperdense fish bone in the stomach, highlighting the superior sensitivity of CT in detecting fish bones compared with radiography. D, E: The fish bones lodged in the esophagus (D) and stomach (E) were successfully removed endoscopically.

Fig. 9

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Drug package blisters, pill packs, and foils ingested when older adults take medications are also associated with significant risk of perforation owing to their sharp edges [5]. They are also typically non-radiopaque, but may be detected on a CT scan (Fig. 10). Dental prostheses, including dentures and implant fixtures, can also be ingested inside or outside dental clinics, and are frequently ingested by older adults (Fig. 11). These objects also result in severe complications such as small bowel perforation owing to their sharp edges [31,32].

Fig. 10. A 66-year-old man complaining of foreign body sensation after taking medicine. A, B: A coronal image from a non-enhanced chest CT scan (lung window) (A) revealed a sharp object (arrow) in the mid-esophagus that is not visible on the corresponding radiograph (B). C: Subsequent endoscopy confirmed that the object was a blister pill foil.

Fig. 10

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Fig. 11. A 75-year-old woman complaining of foreign body sensation after swallowing a denture. A: The chest radiograph revealed a subtle curvilinear radiopaque object (arrow) at the thoracic level. B: Coronal contrast-enhanced CT images demonstrated a hyperdense curvilinear structure (arrow) within the mid-esophagus, consistent with an ingested denture.

Fig. 11

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Long and Wide Objects

Urgent endoscopy is also recommended for objects longer than 6 cm, such as toothbrushes and chopsticks, located in the esophagus or stomach (Fig. 12) [7,9]. Although long objects (≥6 cm) rarely pass through the duodenum, they can penetrate the duodenum [33,34]. Endoscopic removal is recommended for objects wider than 2.5 cm, as they are unlikely to traverse the pylorus [9]. Furthermore, the ASGE guidelines recommend urgent and non-urgent endoscopic removal of objects wider than 2.5 cm in the esophagus and stomach, respectively [9]. Anatomically narrowed areas, such as the pylorus, Treitz’s ligament, and ileocecal valves, impede the passage of long and wide foreign objects [7]. Therefore, if such objects are arrested in these areas for >1 week, endoscopic or surgical removal should be considered [7,35].

Fig. 12. A 55-year-old woman with a history of schizophrenia who ingested a toothbrush. A, B: Chest radiographs revealed the outline of a plastic toothbrush (arrows) posterior to the trachea. Radiopaque wires securing the nylon bristles were visible, whereas the plastic portion of the toothbrush was not apparent on radiography. C: An axial non-contrast CT image displayed the toothbrush (arrow) within the esophagus. D: Owing to the length of the object, urgent endoscopic intervention was performed to successfully remove the toothbrush.

Fig. 12

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Food Bolus

Food bolus impaction is another category of foreign body ingestion [36]. Ingestion of non-food objects occurs more commonly in children; however, food bolus impaction is more common in adults, especially older adults [2,37]. Food boluses can lead to esophageal obstruction (Fig. 13) and are mostly associated with underlying esophageal pathology, such as esophageal web, Schatzki rings, and benign or malignant esophageal strictures [36,37]. A food bolus in the esophagus can be removed endoscopically or pushed into the stomach [1]. However, without confirmation of the underlying esophageal pathology, food bolus impaction may recur [8]. Biopsies are required to diagnose conditions like eosinophilic esophagitis, which is common underlying pathology of esophageal food impaction that appears normal on endoscopy [38,39]. Follow-up diagnostic workups, including endoscopic biopsy and esophagography, are recommended to determine the underlying esophageal pathology [1].

Fig. 13. A 63-year-old man visited the emergency room complaining of a foreign body sensation. A: An unenhanced axial CT image revealed a circular air-containing hyperdense object in the distal esophagus. B: Coronal contrast-enhanced CT showed dilatation of the esophagus proximal to the object. C, D: Endoscopic examination identified the object as a chestnut, which was subsequently removed.

Fig. 13

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Conditions Mimicking Foreign Body Ingestion

Various conditions can mimic foreign body ingestion, causing symptoms such as dysphagia and foreign body sensation. These conditions can be challenging to distinguish from foreign body ingestion, particularly in cases of radiolucent foreign bodies. Conditions mimicking foreign body ingestion include motility disorders, structural or mucosal abnormalities, and extrinsic compression of the pharynx and esophagus (Table 3).

Table 3. Types of mimickers for foreign body ingestion.

Motility disorder Achalasia, diffuse esophageal spasm
Structural or mucosal disorder Zenker’s diverticulum, esophageal stricture, reflux esophagitis, candida esophagitis, eosinophilic esophagitis
Extrinsic compression Extrinsic mass (e.g., thyroid disease, metastatic lymphadenopathy)
Cardiovascular compression (e.g., aberrant right subclavian artery)
Musculoskeletal process (e.g., osteophytes, diffuse idiopathic skeletal hyperostosis)
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Motility disorders such as achalasia present with dysphagia, regurgitation, and chest pain due to impaired esophageal motility and lower esophageal sphincter relaxation, which can be confirmed by esophagography, showing a dilated esophagus with beak-like narrowing [40,41]. Diffuse esophageal spasms cause symptoms similar to chest pain, with simultaneous contractions observed on esophagography as a corkscrew pattern [42,43].

Structural or mucosal conditions include Zenker’s diverticulum, which results in dysphagia and regurgitation due to mucosal herniation in the hypopharynx, which is visible on fluoroscopy [44]. Esophageal strictures can be benign (e.g., peptic strictures from gastroesophageal reflux disease [GERD] and radiation injury) or malignant (e.g., esophageal cancer) [41,45,46]. Esophageal cancer can be identified by esophagography using infiltrative, ulcerative, polypoid, or varicoid patterns [41,47]. Reflux esophagitis, which is also linked to GERD, may cause a foreign body sensation, with esophagography revealing thickened folds and reflux [48]. Candida esophagitis, often observed in immunocompromised patients, appears as longitudinally oriented plaques on esophagography, whereas eosinophilic esophagitis, which is associated with allergies, shows concentric ring-like strictures on esophagography [41,49].

Extrinsic compression from masses, such as thyroid disease, metastatic lymphadenopathy, cardiovascular issues (e.g., aberrant subclavian artery), or musculoskeletal conditions (e.g., osteophytes), can also cause dysphagia, which can be detected on radiological imaging such as CT [41].

CONCLUSION

The evaluation of patients reporting foreign body sensations in the emergency room necessitates accurate differentiation between true foreign body ingestion and mimickers as they require different treatment guidelines. Early diagnosis and intervention are critical for reducing morbidity and mortality in cases of true foreign body ingestion. Imaging modalities, including radiography and CT, can be used to detect and characterize foreign bodies. Additionally, CT helps confirm complications and facilitates procedural planning. Timely endoscopic removal is critical in cases involving ingestion of button batteries, magnets, sharp objects, and long objects. Furthermore, when no foreign body is found on imaging or endoscopy in patients complaining of foreign body sensation, there is a possibility of motility or structural abnormalities in the pharynx or esophagus.

Acknowledgments

We would like to thank Editage (www.editage.co.kr) for English language editing.

Footnotes

Conflicts of Interest: The authors have no potential conflicts of interest to disclose.

Author Contributions:
  • Conceptualization: Sang Min Lee, Song-Ee Baek.
  • Investigation: all authors.
  • Methodology: Sang Min Lee, Min-Jeong Kim.
  • Supervision: Min-Jeong Kim.
  • Visualization: Sang Min Lee.
  • Writing—original draft: Sang Min Lee.
  • Writing—review & editing: all authors.

Funding Statement: None

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