PET CT imaging provides higher sensitivity, specificity and accuracy than conventional imaging for detecting cancer in children. However, there are concerns about radiation exposure from PET CT scans potentially increasing cancer risk. The benefits of PET CT for pediatric oncology patients must be balanced against this radiation risk. PET CT may be appropriate for staging, restaging, treatment response monitoring and residual mass assessment for certain pediatric malignancies when it could improve diagnosis and guide further life-saving treatment.