Noninvasive differentiation of malignant from benign pulmonary nodules and the staging of lung cancer are major challenges and opportunities for radionuclide imaging. Despite the performance of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging in addressing these needs, access to PET imaging in the United States and other countries is still limited for many people. Furthermore, FDG-PET imaging has left room for improvement. Thus, the need for addressing these diagnostic issues exists for a significant portion of the population of the United States and the rest of the world. Labeled antibody and peptide single-photon emission computed tomography imaging offers a reasonable alternative for these indications and comes close to FDG-PET imaging in performance, along with a lower cost when all overhead is included. Although these tracers have a high sensitivity in the diagnosis of primary and metastatic tumors, their specificity is limited by uptake in granulomatous disease, similar to that of FDG-PET. Regardless of these daunting challenges, radiolabeled antibody and peptide imaging deserves a recognized role in the clinical management of lung cancer.