A region of interest is automatically evaluated. The automatic evaluation is based on assessments of one or more characteristics. The one or more characteristics of the region of interest are assessed in a plurality of image data sets acquired by a respective plurality of imaging modalities. In some embodiments, the evaluation is based on assessments of one or more characteristics for each region of interest derived from a combination of structural and functional image data. In one embodiment, the set of structural image data is a set of CT image data and the set of functional image data is a set of PET image data. The one or more lesions may be detected in the structural and/or functional image data by automated routines or by a visual inspection by a clinician or other reviewer.