Lung cancer’s staggering mortality, and our desire to reduce it, draws us repeatedly back to a sometimes heated debate about screening, its suspected benefits, and its known or suspected risks. From a societal perspective, one of the known risks of screening is the potentially immense financial cost. The approach currently under investigation centers on CT scans, which though very sensitive, are lacking in specificity. The result is that smokers (and nonsmokers) have a high rate of detection of lung nodules, but in a large international trial of lung cancer screening, fewer than 10% of prevalent nodules were lung cancer.1 Perhaps more remarkable, even among those with normal baseline CT scans who subsequently developed a lung nodule, fewer than 5% of these “incident” nodules proved to be cancer.1 As a result, health economists are rightfully anxious about the potential costs of screening for lung cancer, much of which may be spent on evaluating those nodules that are benign. One way to reduce the number of invasive procedures (and therefore costs) used to investigate solitary pulmonary nodules (SPNs) is to employ a strategy of watchful waiting on those perceived to be at a low risk. 18Flourodeoxy-glucose (FDG) PET scans have a high negative predictive value and can identify patients whose nodules could be safely managed by serial observation.