***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: PURPOSE To determine the accuracy of breath-hold gadolinium- and perflubron-enhanced magnetic resonance ( MR ) imaging , immunoscintigraphy with indium-111-CYT-103 ( planar and single photon emission computed tomography [ CT ] ) , and contrast material -enhanced CT for the detection of ovarian cancer prior to laparotomy . MATERIAL S AND METHODS Sixteen patients with primary ( n = 3 ) or treated ( n = 13 ) ovarian cancer underwent imaging of the abdomen and pelvis with each modality . All images were review ed prospect ively for tumor location , and results were compared with findings at surgery . RESULTS With CT or MR imaging , tumor was detected in 11 of 13 ( 85 % ) patients compared with 11 of 12 patients ( 92 % ) with immunoscintigraphy .  Per patient accuracy for CT was 81 % compared with 75 % for MR imaging and 86 % for immunoscintigraphy . For detection of individual sites of tumor , the sensitivity of MR imaging  was highest ( 81 % ) compared with CT ( 51 % , P < .001 ) and immunoscintigraphy ( 50 % , P < .01 ) . The combination of MR imaging and  immunoscintigraphy  depicted 89 % of sites of tumor involvement confirmed at laparotomy . CONCLUSION MR imaging and immunoscintigraphy show promise for the evaluation of patients with ovarian cancer The aim of this study was to compare the prognostic value of fluorine-18 fluorodeoxyglucose positron emission tomography ( FDG PET ) with that of second-look laparotomy ( SLL ) in patients with advanced ovarian carcinoma following primary chemotherapy . Fifty-five patients who had undergone cytoreductive surgery and adjuvant chemotherapy for advanced ovarian carcinoma were enrolled in the study . Thirty patients underwent SLL after primary treatment ( SLL group ) , while 25 underwent FDG PET after primary treatment without SLL ( PET group ) . We retrospectively review ed the medical records of the 55 patients for comparison of progression-free interval and disease-free interval between the two groups . Ovarian carcinomas recurred in 37 of the 55 patients . When the progression-free interval and the disease-free interval in patients in the PET group were compared with those in the SLL group , no significant differences were observed . The progression-free interval in the PET and SLL groups were 28.8±12.7 months and 30.6±13.7 months , respectively ( P=0.29 ) . The disease-free interval in the negative PET group was 40.5±11.6 months , and that in the negative SLL group was 48.6±12.1 months ( P=0.12 ) . In conclusion , FDG PET has a similar prognostic value to SLL , and can substitute for SLL in the follow-up of patients who have had ovarian carcinoma , especially when there is a high risk for recurrence OBJECTIVE Recurrence is often a major problem for patients who have undergone surgery for ovarian cancer . This prospect i ve study was undertaken to evaluate the clinical contribution of positron emission tomography ( PET ) using (18)F-fluorodeoxyglucose ( FDG ) for recurrent ovarian cancer . SUBJECTS AND METHODS Twenty-four women who had undergone surgery or chemoradiotherapy for histopathologically proven ovarian cancer were enrolled in this study . Ovarian cancer was thought to have recurred in 12 of these women because of evidence on conventional imaging modalities or tumor marker measurements ( group A ) . Clinical findings for the remaining 12 women showed them to be disease-free ( group B ) . PET findings for the women were compared with the final diagnoses obtained by histopathology or by clinical follow-up . The clinical contribution of PET was assessed by evaluating whether PET yielded information complementing the findings of conventional modalities and by examining its impact on treatment . RESULTS PET gave valuable information for seven of 12 patients in group A in addition to the information obtained from findings on conventional imaging , and treatment was affected in five patients . On the other h and , in group B , additional information was obtained in only three of 12 patients , and treatment of only one patient was affected . Overall sensitivity , specificity , and accuracy of conventional imaging modalities were 72.7 % , 75.0 % , and 73.3 % , respectively , and these rates improved to 92.3 % , 100.0 % , and 94.4 % , respectively , by considering both conventional imaging modalities and PET findings . CONCLUSION Our preliminary data suggest that whole-body PET with FDG can be a complementary modality for following up patients who have had ovarian cancer , especially patients believed to be at risk for recurrence 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 Purpose To evaluate the accuracy of integrated positron emission tomography ( PET ) and computed tomography ( CT ) for depiction of suspected recurrent ovarian carcinoma after treatment , with use of clinical or histological findings as the reference st and ard . Methods Seventy-seven women ( median age , 51 years ) with ovarian carcinoma treated with primary cytoreductive surgery followed by platinum-based combination chemotherapy were included , and [18F]fluorodeoxyglucose ( FDG ) PET/CT was performed for suspected recurrence . In all patients , imaging findings were compared with results of histological examination after surgical exploration or clinical follow-up to determine the diagnostic accuracy of PET/CT in the evaluation of disease status . Fisher ’s exact test was used to measure the ability of PET/CT  to predict recurrent lesions . Results Forty-five ( 58.4 % ) of the 77 patients had documented recurrence during surgical exploration or clinical follow-up , while 32 ( 41.6 % ) had no evidence of recurrent tumour . Of the 45 patients with recurrent disease , 27 ( 60 % ) were confirmed to have recurrence by surgical biopsy . A correlation was found between PET/CT and histological or clinical analyses ( κ = 0.894 ) . The overall sensitivity , specificity , accuracy , positive predictive value and negative predictive value of PET/CT were 93.3 % , 96.9 % , 94.8 % , 97.7 % and 91.2 % , respectively . PET/CT  modified the diagnostic or treatment plan in 19 ( 24.7 % ) patients , by leading to the use of previously unplanned therapeutic procedures in 11 ( 57.9 % ) patients and the avoidance of previously planned diagnostic procedures in eight ( 42.1 % ) patients . Conclusion Integrated FDG PET/CT is a sensitive post-therapy surveillance modality for the detection of recurrent ovarian cancer ; it aids decisions on treatment plans and may ultimately have a favourable impact on prognosis Background Recurrent ovarian cancer is refractory and resistant to treatment in most patients , and no effective treatment for it has been established . Starting a treatment when tumors still consist of micro foci may contribute to improvement of prognosis . Therefore , the early diagnosis of relapse is important . Methods Among patients with epithelial ovarian cancer in whom initial treatment achieved remission between April 1998 and December 2003 , those patients in whom the cancer-related antigen (CA)125 level was increased during the subsequent follow-up period , or those who showed abnormal computed tomography (CT)/magnetic resonance imaging ( MRI ) findings despite normal CA125 levels , were examined by  18F-fluoro-2-deoxyglucose – positron emission tomography ( FDG-PET ) . We compared the rates of accurate diagnosis of recurrence achieved using CT/MRI , CA125 , and FDG-PET in patients with a definitive diagnosis of relapse . Results We investigated 29 patients with epithelial ovarian cancer . The sensitivity , specificity , positive predictive value ( PPV ) , negative predictive value ( NPV ) , and accuracy of  FDG-PET  were 84.6 % ( 22/26 ) , 100 % ( 3/3 ) , 100 % ( 22/22 ) , 42.9 % ( 3/7 ) , and 86.2 % ( 25/29 ) , respectively . These values were higher than the corresponding values obtained using CT/MRI or CA125 levels . Conclusion FDG-PET may be very useful for identifying sites of recurrent ovarian cancer , although this procedure had a low NPV because of the high rate of false-negative findings for micro or cystic lesions PURPOSE To prospect ively evaluate the accuracy of integrated positron emission tomography ( PET ) and computed tomography ( CT ) for depiction of persistent ovarian carcinoma after first-line treatment , with use of histologic findings as the reference st and ard . MATERIAL S AND METHODS Thirty-one women ( mean age , 55.9 years ) with ovarian carcinoma treated with primary cytoreductive surgery and followed up with platinum regimen chemotherapy were included . All 31 patients were scheduled for surgical second-look . Before surgical second-look , all patients underwent fluorodeoxyglucose ( FDG ) PET/CT . At PET/CT , three main categories of persistent disease were considered for data analysis : lymph nodal lesion , peritoneal lesion , and pelvic lesion . In all patients , imaging findings were compared with results of histologic examination after surgical second-look to determine the diagnostic accuracy of PET/CT in the evaluation of disease status . The kappa statistic ( Cohen kappa ) was used for statistical analysis . RESULTS Seventeen ( 55 % ) of 31 patients had persistent tumor at histologic analysis after surgical second-look , and fourteen ( 45 % ) had no histologically proved tumor . The total number of lesions that was positive for tumor cells at histologic analysis was 41 ( lymph nodes , n = 16 ; peritoneal lesions , n = 21 ; pelvic lesions , n = 4 ) ; maximum diameter of these lesions was 0.3 - 3.2 cm ( mean , 1.7 cm ) . A correlation was found between PET/CT and histologic analysis ( kappa = 0.48 ) . The overall lesion-based sensitivity , specificity , accuracy , positive predictive value , and negative predictive value of PET/CT were 78 % , 75 % , 77 % , 89 % and 57 % , respectively . In the detection of a tumor , a size threshold could be set at 0.5 cm , as this was the largest diameter of a lesion missed at PET/CT . CONCLUSION Integrated PET/CT depicts persistent ovarian carcinoma with a high positive predictive value BACKGROUND Borderline ovarian tumors often affect women of childbearing age and the prognosis is outst and ing . Given the young age of several patients and the good prognosis , fertility-sparing surgery is considered adequate for stage I tumors . However , women treated conservatively have a relatively small but well-defined risk of recurrence and no study has specifically addressed the optimal follow-up technique . METHODS From 1981 to 1997 , 164 women underwent fertility-sparing surgery for stage I borderline ovarian tumor and were followed prospect ively . After surgery all women underwent physical examination and ultrasound examination every 3 months for 2 years after first diagnosis and every 6 months thereafter . Measurement of serum CA 125 levels was planned every 6 months in patients with a serous tumor . RESULTS With a median follow-up of 71 , months 28 women treated with fertility-sparing surgery ( 28/164 = 17 % ) had either recurrence of borderline tumor ( 23 ) or recurrence with carcinoma . Complete details of follow-up procedures are available for 24 women and they represent the study population . An abnormal adnexal mass was detected in 18 of 19 women with recurrent borderline tumor . One patient had diagnosis due to persistent free fluid . All five women with invasive carcinoma had diagnosis of a complex adnexal mass . Gynecologic examination was suspicious ( palpable mass ) in 7 cases and obviously abnormal ( large mass or nodules ) in another 7 . CA 125 serum levels were elevated in 8 cases . CONCLUSION Transvaginal ultrasound is 
    Output:
    
The pooled sensitivity , pooled specificity and AUC showed no statistical significance between PET alone and PET-CT .
PET-CT might be a useful supplement to current surveillance techniques , particularly for those patients with an increasing CA 125 level and negative CT or MR imaging .
However , regarding to diagnostic accuracy , interpreted CT images may have limited additional value on PET in detecting recurrent ovarian cancer