We thank Lacout and colleagues [1] for their letter regarding our article [2]. We would agree that an ¹⁸F-FDG PET study fused with a good-quality CT study with IV iodinated contrast administration would be optimal for the assessment and staging of primary lung cancer given the lack of spatial resolution of PET.

Unfortunately, in our region the majority of the PET/CT studies are performed on a mobile van with no facility to administer IV contrast material. The patient would usually have undergone staging with IV contrast-enhanced CT of the thorax and upper abdomen before PET/CT.

Radiotherapy planning is usually performed with CT without IV contrast administration in our facility. We appreciate that FDG may give a false-positive result in cases of consolidation. However, our study showed that unenhanced CT is adequate for radiotherapy planning, and for some patients in the study, FDG PET was helpful where there was adjacent collapse or consolidation or the tumor was close to the mediastinum.