A 45-year-old woman with a history of ovarian cancer presents with recurrent abdominal distension and elevated serum CA-125 (280 U/mL). Which investigation is most appropriate to assess for recurrent disease and guide further management?

Explanation

## Investigation of Choice for Suspected Ovarian Cancer Recurrence **Clinical Scenario:** - History of ovarian cancer + symptoms + elevated CA-125 - Need to confirm recurrence and stage disease for treatment planning **Why CT + CA-125 Correlation is Correct:** - **CT imaging** is the standard imaging modality for detecting recurrent ovarian cancer - **CA-125 trend** provides complementary information (rising levels suggest recurrence) - **Combined approach** (imaging + marker) has highest sensitivity and specificity for recurrence detection - Allows assessment of peritoneal involvement, ascites, and distant metastases - Essential for treatment planning (surgery vs. chemotherapy) **Key Point:** In ovarian cancer surveillance, **imaging + tumor marker correlation is superior to either modality alone**. CA-125 elevation without imaging confirmation may be false-positive; imaging without marker context may miss early recurrence. **High-Yield:** CA-125 is most useful in **trending over time** and **correlating with imaging**; a single elevated value requires imaging confirmation.