Specifically, in patients with a history of colon cancer, lesion characterization on contrast-enhanced CT is correct in 77% of cases [41]. In patients with hypervascular liver metastases, adding a noncontrast CT phase to a contrast-enhanced CT examination can improve the confidence level for lesion characterization by 4% to 15%; however, it does not change the diagnostic accuracy [43]. The addition of noncontrast CT can increase sensitivity for breast cancer metastases by 5% to 23% but does not improve sensitivity for melanoma metastases [44]. Sensitivity of noncontrast CT alone is 61% to 100% for breast cancer metastases, 62% to 100% for melanoma metastases, and 17% to 88% for NET metastases [44]. In comparison, contrast-enhanced CT has a sensitivity of 77% to 95% for breast cancer metastases, 86% to 100% for melanoma metastases, and 44% to 82% for NET metastases [44,45]. FDG-PET/CT Skull Base to Mid-Thigh In patients with a history of primary malignancy, FDG-PET/CT can differentiate between malignant and benign lesions with an accuracy of 75% [40]. In patients with a history of primary cancer and indeterminate lesions found by either CT or MRI, FDG-PET/CT has an accuracy of 75% with a high sensitivity of 96% and a limited specificity of 33% [40]. The sensitivity and specificity of FDG-PET/CT in the detection of hepatic metastases is 97% and 75%, respectively, which is higher compared with contrast-enhanced CT alone (which as a sensitivity and specificity of 88% and 17%, respectively) [42]. DOTATATE PET/CT Skull Base to Mid-Thigh In patients with primary NET, Ga-68-DOTATATE PET/CT demonstrates sensitivity of 80% to 100% and specificity of 82% to 100% [8]. Specifically, Ga-68-DOTATATE PET/CT is more sensitive than FDG-PET/CT, with sensitivities of 72% to 100% versus 54% to 78%, respectively [8]. Liver Lesion-Initial Characterization
Liver Lesion Initial Characterization. Specifically, in patients with a history of colon cancer, lesion characterization on contrast-enhanced CT is correct in 77% of cases [41]. In patients with hypervascular liver metastases, adding a noncontrast CT phase to a contrast-enhanced CT examination can improve the confidence level for lesion characterization by 4% to 15%; however, it does not change the diagnostic accuracy [43]. The addition of noncontrast CT can increase sensitivity for breast cancer metastases by 5% to 23% but does not improve sensitivity for melanoma metastases [44]. Sensitivity of noncontrast CT alone is 61% to 100% for breast cancer metastases, 62% to 100% for melanoma metastases, and 17% to 88% for NET metastases [44]. In comparison, contrast-enhanced CT has a sensitivity of 77% to 95% for breast cancer metastases, 86% to 100% for melanoma metastases, and 44% to 82% for NET metastases [44,45]. FDG-PET/CT Skull Base to Mid-Thigh In patients with a history of primary malignancy, FDG-PET/CT can differentiate between malignant and benign lesions with an accuracy of 75% [40]. In patients with a history of primary cancer and indeterminate lesions found by either CT or MRI, FDG-PET/CT has an accuracy of 75% with a high sensitivity of 96% and a limited specificity of 33% [40]. The sensitivity and specificity of FDG-PET/CT in the detection of hepatic metastases is 97% and 75%, respectively, which is higher compared with contrast-enhanced CT alone (which as a sensitivity and specificity of 88% and 17%, respectively) [42]. DOTATATE PET/CT Skull Base to Mid-Thigh In patients with primary NET, Ga-68-DOTATATE PET/CT demonstrates sensitivity of 80% to 100% and specificity of 82% to 100% [8]. Specifically, Ga-68-DOTATATE PET/CT is more sensitive than FDG-PET/CT, with sensitivities of 72% to 100% versus 54% to 78%, respectively [8]. Liver Lesion-Initial Characterization