The aim of achieving an accurate diagnosis and stage of lung cancer is to ensure that patients can be offered the most appropriate treatment. Investigations should yield the required level of diagnostic and staging information with least risk and discomfort for the patient. It is vital that this is in line with the patient’s wishes and appropriate to their fitness as well as the potential treatment. To do this, contrast-enhanced computed tomography (CT) of the lower neck, chest, liver and adrenals should be available for most patients at the first clinical assessment.