***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 PURPOSE To assess magnetic resonance ( MR ) imaging in depiction of ovarian tumor recurrence and for identification of patients who may not benefit from surgical reexploration . MATERIAL S AND METHODS In a prospect i ve study , 34 patients ( mean age , 57.07 years ) with surgically staged ovarian cancer underwent MR imaging before reexploration . Findings at MR imaging and surgery were correlated . MR imaging tumor depiction was correlated with tumor size , presence of ascites , and CA-125 levels . RESULTS Tumor recurrence was identified in 29 patients at surgery .  MR imaging depicted tumor in 20 patients . Accuracy for lesions smaller than 2 cm was 35 % and increased to 82 % for lesions larger than 2 cm ( P < .01 ) . MR imaging had low sensitivity for depiction of implants in the peritoneum and mesentery . Ascites improved depiction of smaller lesions ( < 2 cm ) . MR imaging in combination with CA-125 levels improved detection of recurrent disease ( CA-125 measurement alone 53 % vs CA-125 measurement and MR imaging 75 % , P = .048 ) . CONCLUSION MR imaging is a useful adjunct to the clinical examination to identify patients with recurrent disease and those in whom reexploration may not be beneficial 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 This study was to evaluate the clinical impact of whole body positron emission tomography ( PET ) with 18F-fluoro-2-deoxyglucose ( FDG ) to detect recurrent cervical cancer based on asymptomatically elevated tumor marker levels . Whole-body FDG-PET  was performed in 20 patients with suspected recurrent squamous cell carcinoma ( SCC ) of the cervix and asymptomatic tumor marker of SCC antigen increased serum levels but negative or equivocal other imaging modality results . All of these 20 asymptomatic patients have serum levels of SCC antigen > 1.5 ng/mL. The final diagnosis of recurrent cervical cancer was established by operation/biopsy histopathological findings or clinical follow-up after more than 1 year by additional morphological imaging techniques . Among the 20 patients , the final diagnosis of recurrent cervical cancer was established in 81 lesions of 19 patients . The FDG-PET accurately detected 78/81 lesions . With asymptomatically elevated SCC antigen serum levels , the diagnostic sensitivity and accuracy of FDG-PET to detect recurrent cervical cancer lesions were 97.5 % and 94.0 % , respectively . The FDG-PET is a useful technique to detect recurrent cervical cancer for patients with asymptomatically elevated SCC antigen serum levels UNLABELLED The aim of this study was to evaluate the role of serum CA125 levels and computerized tomography ( CT ) scans in predicting pathologic response of intraperitoneal chemotherapy in patients with ovarian cancer . We prospect ively analyzed serum CA125 levels and abdominopelvic CT scans obtained after the completion of intraperitoneal chemotherapy in 52 patients with ovarian cancer and compared the results with subsequent laparotomic findings , which served as the gold st and ard for statistical analysis . Laparatomy revealed either microscopic or macroscopic residual disease in 20 patients , while 32 patients were completely tumor-free . CA125 levels correlated significantly with laparotomic findings ( p=0.003 , u=1405 ) . Median CA125 values in patients with residual tumors and in tumor-free patients following intraperitoneal chemotherapy were 14.6 ( 1 - 775 ) and 7.2 ( 1 - 37 ) U/ml , respectively . Although CT-imaging and CA 125 levels had a high specificity ( 100 % and 96.9 % , respectively ) , they showed a low sensitivity rate ( 50 % and 40 % , respectively ) . Similarly , despite high positive predictive values ( 100 % and 88.9 % , respectively ) , the negative predictive values were 76.2 % and 72.1 % , respectively . CONCLUSION Although highly specific , CT scans and CA125 levels do not accurately indicate the presence of disease . Due to a high false-negative rate , a normal CT scan or a normal CA125 value is not sufficient to replace a laparotomy 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 . Les 
    Output:
    
Conclusion Both PET and PET/CT have good performance in the detection of recurrent cervical cancer .
However , interpreted CT images may have limited additional value on PET in detecting recurrent cervical cancer