Background: Guidance for conducting Cochrane systematic reviews of effects and diagnostic test accuracy (DTA) studies recommends handsearching be considered to enhance the retrieval of relevant studies. However, there is little published evidence of the benefits of handsearching for reports of DTA studies. Objectives: This study investigated the contribution of handsearching to identifying studies for a review of DTA of 18F-FluoroDeoxyGlucose – Positron Emission Tomography – Computerised Tomography (18F FDG-PET-CT) for colorectal cancer. Methods: Candidate journals to handsearch were identified by selecting reviews of FDG-PET for colorectal cancer and collecting the references of the studies included in those reviews. The ten highest yielding journals towhich we had electronic access were handsearched from 2005 to June 2009. The results of the handsearch were compared with the results of database searches conducted for the systematic review for the same years. Results: 573 journal issues were handsearched in 185 hours yielding 25 candidate DTA records. 1 candidate record per 7.4 hours of handsearching. The handsearch yielded previously unexamined reports, but none were relevant. Of the 29 studies included in the review (retrieved by database searching) only three were published in the handsearched journals. Conclusions: Handsearching is time consuming and expensive. In this review, handsearching did not yield unique studies relevant to FDG-PET-CT in addition to database searching and reference checking. This may be because the databases searches were highly sensitive and FDG-PET-CT studies tend to be consistently described and hence easier to retrieve. Handsearching may be more helpful for less clearly defined diagnostic tests. Identifying the highest yield journals to handsearch for imaging studies is problematic because studies are published in journals from many disciplines.