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Background Lung cancer NICE (National Institute for Health and Care Excellence) guidelines suggest investigating suspected early-stage lung cancer with a contrast-enhanced staging CT imaging and PET-CT. NICE guidelines suggest contrast CT should include liver, adrenals and lower neck. In practice non-enhanced CT thorax is often followed by PET-CT, while staging CT is often omitted. There is no consensus among clinicians if staging CT adds additional diagnostic value.Aims To evaluate whether staging CT demonstrates clinically relevant new findings in addition to PET-CT.Methods Retrospective review of 280 patients, who underwent PET-CT for suspected primary lung cancer (March 2023 – November 2024).Results The cohort included 136 males (48.6%) and 144 females (51.4%) with a mean age of 71.1 years (range: 40–95). The majority had PET staging of T1a, T1 b and T1c (220/280, 78.6%), followed by T2a and T2b (36/280,12.8%) and T3, T4 (24/280, 8.6%). Nodal staging was predominantly N0 (260/280, 92.9%), whereas 20/280 (7.1%) were Nx.A single suspicious nodule was found in 216 patients (77.1%), while 47 (16.7%) had two nodules and 17 (6.1%) had three or more. Malignancy was confirmed histologically in 148/280 patients (52.9%) via biopsy and/or post-surgery.CT was performed in addition to PET-CT in 160/280 patients (57.1%). Only one patient (0.6%) had significant additional findings on CT, revealing liver metastasis. However, the seven-month interval between PET-CT and CT-AP suggests disease progression rather than a missed finding.Conclusions When early-stage lung cancer is suspected on thoracic CT, PET-CT demonstrates reliable diagnostic accuracy, while staging CT scan generally does not provide additional clinically significant information beyond that obtained through PET-CT.