PET-CT is the most important imaging tool for lung cancer analysis and better than CT or FDG-PET alone, but not optimal for determination of tumour invasion in mediastinal or other adjacent structures. MRI is more suitable for this purpose, but is limited available. EUS-FNA (carinal lymph nodes), eventually in combination with CT or FDG-PET and EBUS-TBNA (right mediastinal lymph nodes), superior to TBNA alone, are novel imaging techniques with a high accuracy. Bronchoscopy provides information on tumour type and resectability of centrally but not peripherally located tumours. Mediastinal staging can be performed by adding TBNA to bronchoscopy with high accuracy. PET-CT, as a superior imaging mode, could direct for the best subsequent endoscopic technique for obtaining a tissue diagnosis as well as leading to a more comprehensive staging of patients with suspected lung cancer.