The use of Positron Emission Tomography (PET) with Computed Tomography (PET/CT) is rapidly expanding in childhood cancers including brain tumors, lymphomas, soft tissue tumors, and bone tumors such as osteosarcoma and Ewing sarcoma, thyroid cancers and rare tumors. Clinical applications of PET/CT in children with brain tumors include: to evaluate for recurrent tumor, to differentiate between recurrent tumor and post-treatment necrosis, to localize the areas of high grade disease in order to guide biopsy and treatment planning. Clinical applications of PET/CT in children with lymphomas include: initial staging of patients to determine the extent of disease, to determine response to chemotherapy or radiation therapy, post-chemotherapy assessment for patients with advanced stage of aggressive non-Hodgkin′s lymphoma, and Hodgkin′s lymphoma with residual CT abnormalities or initial bulky disease, to plan the duration of chemotherapy for patients with Hodgkin′s and non-Hodgkin′s lymphoma, and to plan the duration and the type of treatment for limited stage of aggressive lymphoma. FDG uptake is generally greater in higher grade than lower grade lymphomas. FDG-PET reveals disease sites that are not detected by conventional staging methods, resulting in upstaging of disease with potential therapeutic review.FDG-PET is useful for assessing the need for bone marrow biopsy, and residual or recurrent soft tissue masses seen on CT after therapy. Clinical applications of PET/CT in children with sarcomas include: to evaluate the primary soft tissue mass prior to biopsy to identify high grade areas and to guide biopsy, for staging of locally advanced high grade soft tissue sarcomas, for detecting of suspected local recurrence of soft tissue sarcoma after definitive treatment, for staging of Ewing′s sarcoma, and for initial staging and evaluation of potential recurrence in osteosarcoma. Clinical applications of PET/CT in children with neuroblastomainclude: evaluation of the extent of viable tumor tissue in primary tumor, staging and disease evaluation of MIBG-negative tumors, evaluation of residual mass or primary site for recurrent or residual tumor at post-treatment stage particularly if conventional studies are not helpful or equivocal, as well as evaluation for local recurrence or distant metastases at post-treatment stage or marrow transplantation. [11C]-Hydroxyephedrine ([11C]-HED), an analogue of norepinephrine, and [11C]-epinephrine PET have also been used in evaluating neuroblastoma. Uptake of these tracers is demonstrated within minutes after tracer administration, an advantage over MIBG imaging. In osteosarcoma and Ewing’s sarcoma, FDG-PET may play an important role in monitoring response to therapy. Another diagnostic role may be in assessing patients with suspected metastatic disease. Clinical applications of PET/CT in children with thyroid cancers include: detection and localization of suspected recurrence after definitive therapy in patients with elevated thyroglobulin levels and negative radioiodine scan (papillary and follicular carcinomas). Thyroid “incidentalomas” found on 18 FDG scanning appear to have a high rate of malignancy and should be assessed by fine-needle aspiration. Clinical applications of PET/CT in children with rare tumors include: monitoring hepatoblastomas during and after therapy by FDG-PET.