***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: Abstract Background : To evaluate the usefulness of dynamic and delayed magnetic resonance ( MR ) imaging in the T-staging of stomach cancer and to compare the enhancement pattern of the cancerous lesion and the normal wall . Methods : We performed MR imaging in 46 patients with stomach cancer ( including four early gastric cancers and 42 advanced gastric cancers ) . Axial , sagittal , or coronal two-dimensional fast low-angle shot ) MR images for the water-distended stomach were obtained with dynamic protocol , including precontrast images and images obtained 30 , 60 , 90 , and 240–300 s after intravenous injection of the 0.1 mM Gd-DTPA/kg solution . We evaluated the thickness , interruption ( or not ) of the low signal intensity b and s , and enhancement pattern of the cancerous wall and normal gastric wall . We prospect ively evaluated the depth of cancer invasion , perigastric infiltration ( extraserosal invasion ) , perigastric organ invasion , and regional lymph nodes and determined tumor staging on MR images . These MR evaluations including MR-determined staging were correlated with the surgicopathologic findings . Results : Stomach cancer was shown as having a thickened wall with a rapid enhancing pattern after intravenous Gd-DTPA administration . The mucosa ( and /or submucosa ) affected by stomach cancer showed an early enhancement pattern ( 30–90 s after Gd-DTPA administration ) in 43 of 46 patients ( 93 % ) . The normal gastric mucosa demonstrated a delayed peak enhancement pattern ( > 90 s after Gd-DTPA administration ) in 29 of 46 patients ( 63 % ) and variable enhancement pattern in 17 of 46 patients ( 37 % ) . An interrupted low signal intensity b and or highly enhanced tumorous lesion penetrating through the gastric wall was seen in 17 of 19 pT3 patients ( 90 % ) . Consistency between MR-determined staging and surgicopathologic staging occurred in three of four pT1 tumors ( 75 % ) , 10 of 13 pT2 tumors ( 77 % ) , 17 of 19 pT3 tumors ( 90 % ) , and eight of 10 pT4 tumors ( 80 % ) ; overall accuracy was 83 % . Overall accuracy of regional lymph node involvement , as determined by enhanced MR , was 52 % ; 24 of 46 node groups were positive . Conclusions : Dynamic and delayed MR imaging can be useful for predicting depth of cancer invasion , perigastric infiltration ( extraserosal invasion ) , and perigastric organ invasion by gastric cancer Objective To determine the accuracy of the preoperative staging of uterine cervical cancer by  magnetic resonance ( MR ) imaging  in 115 patients in a prospect i ve study . Methods A prospect i ve study was performed in 115 patients who underwent MR imaging at 1.5 T before surgery or biopsy .  Histopathologic findings were correlated with MR imaging results for all patients . Results The accuracy of preoperative tumor staging by MR imaging in the 115 patients was 77 % . In terms of the evaluation of parametrial status , this study had an accuracy of 94 % and a sensitivity of 38 % . The accuracy and sensitivity of MR imaging for vaginal invasion were 81 % and 87 % , respectively . In terms of lymph node metastasis , this study had an accuracy of 97 % and a sensitivity of 36 % . Conclusion Magnetic resonance imaging has high accuracy in the preoperative staging of uterine cervical cancer PURPOSE To assess magnetic resonance ( MR ) imaging in depicting the depth of myometrial infiltration , cervical invasion , and presence of enlarged lymph nodes in patients with endometrial adenocarcinoma compared with surgicopathologic findings . MATERIAL S AND METHODS Thirty-seven consecutive patients with endometrial carcinoma were included in this prospect i ve study . All patients underwent MR imaging and surgery .  Qualitative image analysis included the depth of myometrial infiltration , infiltration of the uterine cervix , and presence of enlarged lymph nodes . Quantitative image analysis included tumor and myometrium contrast-to-noise ratios during different phases of dynamic imaging . MR imaging findings were compared with surgicopathologic findings . Sensitivity , specificity , diagnostic accuracy , and positive and negative predictive values of MR imaging in depicting myometrial and cervical infiltration and in lymph node assessment were calculated . RESULTS Respective sensitivity , specificity , diagnostic accuracy , and positive and negative predictive values in assessing myometrial infiltration were 87 % , 91 % , 89 % , 87 % , and 91 % ; those for cervical infiltration , 80 % , 96 % , 92 % , 89 % , and 93 % ; and those for lymph node assessment , 50 % , 95 % , 90 % , 50 % , and 95 % . There was significant agreement between MR imaging and surgicopathologic findings in assessment of myometrial invasion ( P < .001 ) . Myometrial and cervical invasion and lymph node enlargement were correctly assessed with MR imaging in 28 ( 76 % ) of 37 patients . Quantitative analysis showed a significant improvement in tumor and myometrium contrast-to-noise ratios during the equilibrium phase compared with the arterial and precontrast phases ( P < .001 ) . CONCLUSION MR imaging coupled with contrast material -enhanced dynamic MR imaging is highly accurate in local-regional staging of endometrial carcinoma ; more challenging is the assessment of pelvic and lumboaortic lymph nodes PURPOSE To evaluate the accuracy of a non-invasive " all-in-one " staging MR method in patients with pancreatic tumors . MATERIAL AND METHODS 46 patients were prospect ively evaluated by a combined MR imaging protocol including breath-hold T1- and T2-weighted pulse sequence , MRCP using a breath-hold 2D-RARE sequence , and breath-hold gadolinium-enhanced dual-phase 3D-MR angiography . RESULTS All pancreatic tumors were detected by the combination of cross-sectional imaging and MRCP . In spite of the use of MRCP , definitive differentiation between pancreatic carcinoma and chronic pancreatitis was not possible in 3 ( 6.5 % ) out of 46 cases . High quality 3D-MR angiograms were obtained in 43 ( 93.5 % ) cases . In 6 ( 13 % ) patients 3D-MRA showed an aberrant right hepatic artery . The overall accuracy of MRI in assessing extrapancreatic tumor spread , lymph node metastases , liver metastases , and vascular involvement was 95.7 % , 80.4 % , 93.5 % , and 89.1 % , respectively . CONCLUSION Due to its high accuracy , the " all-in-one " MR protocol may become the most important modality after clinical examination and ultrasound in the diagnostic work-up for most patients with suspicion of pancreatic tumors BACKGROUND In patients with prostate cancer who are deemed to be at intermediate or high risk of having nodal metastases , invasive diagnostic pelvic lymph-node dissection ( PLND ) is the gold st and ard for the detection of nodal disease . However , a new lymph-node-specific MR-contrast agent ferumoxtran-10 can detect metastases in normal-sized nodes ( ie , < 8 mm in size ) by use of MR lymphoangiography ( MRL ) . In this prospect i ve , multicentre cohort study , we aim ed to compare the diagnostic accuracy of MRL with up-to- date multidetector CT ( MDCT ) , and test the hypothesis that a negative MRL finding obviates the need for a PLND . METHODS We included consecutive patients with prostate cancer who had an intermediate or high risk ( risk of > 5 % according to routinely used nomograms ) of having lymph-node metastases . All patients were assessed by MDCT and MRL , and underwent PLND or fine-needle aspiration biopsy . Imaging results were correlated with histopathology . The primary outcomes were sensitivity , specificity , accuracy , NPV , and PPV of MRL and MDCT .  This study is registered with Clinical Trials.gov , number NCT00185029 . FINDINGS The study was done in 11 hospitals in the Netherl and s between April 8 , 2003 , and April 19 , 2005 . 375 consecutive patients were included . 61 of 375 ( 16 % ) patients had lymph-node metastases . Sensitivity was 34 % ( 21 of 61 ; 95 % CI 23 - 48 ) for MDCT and 82 % ( 50 of 61 ; 70 - 90 ) for MRL ( McNemar 's test p<0.05 ) . Specificity was 97 % ( 303 of 314 ; 94 - 98 ) for MDCT and 93 % ( 291 of 314 ; 89 - 95 ) for MRL . Positive predictive value ( PPV ) was 66 % ( 21 of 32 ; 47 - 81 ) for MDCT and 69 % ( 50 of 73 ; 56 - 79 ) for MRL . Negative predictive value ( NPV ) was 88 % ( 303 of 343 ; 84 - 91 ) for MDCT and 96 % ( 291 of 302 ; 93 - 98 ) for MRL ( McNemar 's test p<0.05 ) . Of the 61 patients with lymph-node metastases , 50 were detected by MRL , of which 40 ( 80 % ) had metastases in normal-sized lymph nodes . The high sensitivity and NPV of MRL imply that in patients with a negative MRL , the chance of positive lymph nodes is less than 11/302 ( 4 % ) . INTERPRETATION MRL had significantly higher sensitivity and NPV than MDCT for patients with prostate cancer who had intermediate or high risk of having lymph-node metastases . In such patients , after a negative MRL , the post-test probability of having lymph-node metastases is low enough to omit a PLND OBJECTIVE In several previous studies , including one of our own , CT and MRI provided similar information on N2 detection in the staging of lung cancer . Both imaging techniques can be considered effective in detecting enlarged mediastinal lymph nodes but the results are often inaccurate when confronted with pathological findings . The purpose of this study was to assess the diagnostic accuracy of gadolinium-DTPA enhanced MRI in the detection of mediastinal lymph nodes in lung cancer . METHODS A prospect i ve study to compare st and ard unenhanced MRI and Gd-DTPA enhanced MRI was carried out in patients with diagnosed lung cancer . The study focused on the status of mediastinal lymph nodes . Gd-DTPA was administered at a dosage of 0.2 mmol2/KG before T1 weighted sequences . Qualitative visual analyses of both st and ard and contrast enhanced MRI images were performed on each patient by 2 independent radiologists . The imaging results were then compared to pathological findings obtained after surgical operation . RESULTS In the identification of mediastinal lymph node metastases  st and ard MRI was 62 % sensitive , 100 % specific and 74 % accurate whereas Gd-DTPA enhanced MRI was 100 % sensitive , 91 % specific and 97 % accurate . CONCLUSIONS Gd-DPTA enhanced MRI was more accurate than st and ard MRI in the detection of metastatic lymph nodes in patients with lung cancer . These initial results can be considered encouraging especially with regards to the reduction of false negative findings although further confirmation is , underst and ably , required Abstract Background : We retrospectively evaluated the accuracy of magnetic resonance ( MR ) imaging in staging colorectal cancer and assessing local tumor extent , nodal involvement , and distant abdominal and pelvic metastases . Methods : Forty-eight patients with primary colorectal carcinoma were referred for presurgical abdominal and pelvic MR imaging . MR imaging included T1-weighted , fat-suppressed T2-weighted , and fat-suppressed gadolinium-enhanced spin gradient-echo imaging . The prospect i ve interpretations of the MR examinations were review ed . MR depiction of local tumor extent , nodal involvement , and distant metastases at 18 anatomic locations was noted and compared with subsequent surgical and histopathologic findings . Results : Overall TNM MR staging agreed with surgical and pathologic staging in 41 ( 85 % ) of 48 patients , including 21 ( 78 % ) of 27 colon cancers and 20 ( 95 % ) of 21 rectal cancers . For depth of tumor penetration , which was evaluable in 44 patients , MR imaging agreed with pathologic results in 38 ( 86 % ) of 44 patients , including 22 ( 88 % ) of 25 colon cancers and 16 ( 84 % ) of 19 rectal cancers . In 42 ( 95 % ) of 44 patients , MR images correctly distinguished tumor confined to the bowel wall ( T0 , T1 , and T2 ) from tumor with transmural tumor extension ( T3 and T4 ) . Regional nodal metastases were depicted in  
    Output:
    
The overall accuracy of gadolinium-enhanced magnetic resonance imaging for the detection of nodal metastases is moderate .
Incorporating contrast enhancement in the malignancy criteria substantially improves the accuracy of this diagnostic test