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Increasing access to positron emission tomography-computed tomography (PET-CT) has resulted in a shift towards functional imaging, being the primary tool in the assessment of viable tumour in oncology patients. In this review, we discuss the basic principles of this evolving technology and the radio-isotopes it employs. The main clinical applications of PET-CT are reviewed and some of the limitations of the technique are highlighted. Finally, we offer insight into possible future developments and how these modify current practice.