The rapid technological advances of positron emission tomography–computed tomography (PET-CT) have introduced many new possibilities and questions as to how best to utilize and perform 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) PET-CT for maximum clinical benefit. The focus of this discussion is the tailoring of PET-CT protocols, emphasizing the incorporation of optimized (diagnostic) CT techniques, for adult thoracic oncologic indications. Many of the protocol strategies described, particularly those involving breath-hold and contrast-enhanced CT, are based on the author's experience in a busy private practice PET-CT center, prior to a recent transition to an academic practice.