***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: During follow‐up for patients with cervical carcinoma , elevation of serum squamous cell carcinoma antigen ( SCC‐Ag ) levels in the absence of detectable recurrent lesions presents a diagnostic and therapeutic challenge . In the current prospect i ve study , the authors evaluated the use of fluorine‐18‐labeled fluoro‐2‐deoxy‐D‐glucose ( FDG ) positron emission tomography ( PET ) to detect disease recurrence in this setting OBJECTIVE To evaluate the diagnostic accuracy of integrated positron emission tomography/computerized tomography ( PET/CT ) in patients with gynecological cancer . METHODS Fifty-three consecutive patients with gynecologic malignancies were included . The patients were referred to our tertiary center to undergo a PET/CT scan . The sensitivity , specificity , positive predictive value ( PPV ) and negative predictive value ( NPV ) of PET/CT were compared with the conventional imaging assessment s [ CT , magnetic resonance imaging ( MRI ) and ultrasonography ( US ) ] . RESULTS All tested values were higher for PET/CT than those for the conventional modalities : sensitivity 0.97 vs. 0.40 , specificity 0.94 vs. 0.65 , PPV 0.97 vs. 0.70 , and NPV 0.94 vs. 0.34 , respectively . CONCLUSION PET/CT is a reliable modality for assessing the extent of disease in patients with gynecologic malignancy OBJECTIVE The purpose of this study was to determine whether positron emission tomography ( PET ) using F-18-fluorodeoxyglucose ( FDG ) before and after radiotherapy would predict whether local control of cervical cancer had been achieved . METHODS FDG-PET scans were performed prior to therapy and at a mean of 4.6 months after radiation in 20 patients ( pts ) with histologically proven uterine cervical cancer who were undergoing a " curative " course of radiation therapy .  FDG uptake was interpreted visually by two readers using a 5-point grading system ( 0 = normal , 1 = probably normal , 2 = equivocal , 3 = probably abnormal , and 4 = definitely abnormal ) . The st and ardized uptake values corrected by lean body mass ( SUL ) were calculated for suspicious areas . The percentage of residual activity ( % RA ) for the posttherapy SUL was also evaluated as a percentage of the pretherapy SUL . RESULTS At baseline before irradiation , 17 of 20 ( 85.0 % ) primary tumors were detected . Following irradiation , no or low ( grade 0 - 2 ) uptake was observed in 9 pts , and none of these had local recurrence . Among the remaining 11 pts with grade 3 or 4 uptake , the correct diagnosis was made for 5 pts with active tumor ; SULs ( mean + /- SD = 4.17 + /- 2.52 ) and % RAs ( 57.9 + /- 16.8 ) . Six patients without active tumor showed relatively low SULs ( 2.67 + /- 0.69 ) and % RAs ( 43.0 + /- 18.3 ) . No significant differences were observed between the recurrent and nonrecurrent groups for these parameters . Overall , sensitivity , specificity , and accuracy were 100 , 60 , and 70 % , respectively . CONCLUSION These preliminary data indicate that FDG-PET is a sensitive tool for detecting active cervical cancer after radiation , however , the method , without anatomic correlation had suboptimal specificity OBJECTIVES [ (18)F ] Fluoro-2-deoxyglucose positron emission tomography ( FDG PET ) has recently been established as a sensitive and specific method of detecting lymph node metastases in newly diagnosed cervical cancer . Little is known about the efficacy of PET for detecting recurrent disease . We evaluated the potential role of FDG PET in the context of suspected recurrent cervical cancer . METHODS The records of patients undergoing PET scan to evaluate for cervical cancer recurrence between July 1998 and February 2002 were review ed . Radiographic findings were classified as negative , suspicious , or equivocal . PET scan findings were compared to available clinical data to classify each PET result as a true positive , true negative , false positive , or false negative . Clinical proof of recurrence consisted of a tissue biopsy revealing recurrent cancer within 3 months of the PET scan . Clinical proof of no evidence of disease consisted of a negative tissue biopsy within 3 months or no clinical evidence of recurrence within 6 months after the PET scan . RESULTS Twenty-eight patients underwent 37 PET scans . Twenty-nine cases among 22 patients were clinical ly evaluable for recurrence status . Median age was 42 , and stage distribution was IB 1 ( n = 3 ) , IB2 ( n = 4 ) , IIA ( n = 1 ) , IIB ( n = 10 ) , IIIB ( n = 9 ) , IVB ( n = 1 ) . Histologic types included squamous ( n = 23 ) adenocarcinoma ( n = 4 ) and unknown ( n = 1 ) . There were 12 true positive PET scans , 13 true negatives , 2 false positives , and 2 false negatives . The sensitivity and specificity of FDG PET for detecting recurrent cervical cancer were 85.7 and 86.7 % , respectively . The positive and negative predictive values were 85.7 and 86.7 % , respectively . CONCLUSIONS Whole-body FDG PET is a sensitive and specific tool for the detection of recurrent cervical cancer  in patients who have clinical findings suspicious for recurrence . A larger prospect i ve trial will determine whether this modality should be used routinely in conjunction with , or in lieu of , other imaging studies to detect recurrent disease in a broader population of cervical cancer patients UNLABELLED PET with 18F-FDG has shown its potential in cervical cancer . For maximizing the benefits of this new imaging technology , we aim ed to define the prognostic features of recurrent cervical cancer patients for selecting appropriate c and i date s using 18F-FDG PET . METHODS Patients enrolled were from 2 independent prospect i ve studies investigating the role of 18F-FDG PET in cervical cancer patients after definitive treatment with documented failure ( CTRP-018 ) or unexplained elevated tumor marker serum levels ( CTRP-016 ) and proven relapse after PET . A total of 55 eligible patients received PET and CT or MRI .  Lesion status was determined from pathologic results or clinical follow-up . The benefits calculated were based on treatment that was modified because of the PET findings . The Cox proportional hazards ratio ( HR ) was used to select independent prognostic covariates . RESULTS Thirty-six ( 65.5 % ) patients had treatment that was modified due to PET . Primary radiation ( HR = 14.62 ; 95 % confidence interval [ CI ] = 2.74 - 77.92 ) , squamous cell carcinoma antigen ( SCC-Ag ) > or = 4 ng/mL ( HR = 5.82 ; 95 % CI = 1.53 - 22.04 ) , and presence of symptoms ( HR = 6.24 ; 95 % CI = 1.99 - 19.61 ) at recurrence were significant factors associated with poor survival . A scoring system using these covariates defined 3 distinct prognostic groups : score < or = 1 ( HR = 1.00 ) ; score = 2 ( HR = 6.91 ; 95 % CI = 1.49 - 32.14 ) ; and score = 3 ( HR = 60.46 ; 95 % CI = 9.68 - 378.09 ) ( P < 0.0001 ) . CONCLUSION Using this risk score , 18F-FDG PET may offer maximal benefits by selecting appropriate recurrent cervical cancer patients for salvage therapy with precise restaging information Purpose The purpose of this study was to prospect ively determine the diagnostic accuracy of PET/CT in the detection of recurrence in patients with treated uterine cancers . Methods Twenty-five women , ranging in age from 37 to 79 years ( mean 58.9 years ) , who underwent primary surgical treatment for either a cervical or an endometrial cancer met the inclusion criterion of the study , which was suspicion of recurrence based on results of routine follow-up procedures . PET/CT was performed after administration of 18F-fluorodeoxyglucose ( FDG ) ; two readers interpreted the images in consensus . Histopathological findings or correlation with results of subsequent clinical and imaging follow-up examinations served as the reference st and ard . Diagnostic accuracy of PET/CT was reported in terms of the proportion of correctly classified patients and lesion sites . Results Tumour recurrence was found at histopathological analysis or follow-up examinations after PET/CT in 14 ( 56 % ) of the 25 patients . Patient-based sensitivity , specificity , positive predictive value , negative predictive value and accuracy of PET/CT for detection of tumour recurrence were 92.9 % , 100.0 % , 100.0 % , 91.7 % and 96.0 % , respectively . Lesion site-based sensitivity , specificity , positive predictive value , negative predictive value and accuracy of PET/CT  were 94.7 % , 99.5 % , 94.7 % , 99.5 % and 99.0 % , respectively . Conclusion This preliminary study shows that PET/CT may be an accurate method for the evaluation of recurrence in patients who have been treated for uterine cancers and are undergoing follow-up 
    Output:
    
F-FDG-PET and PET-CT are valuable methods for the assessment of recurrent cervical cancer