OBJECTIVE: To evaluate the prevalence of exclusive lower extremity metastases, specifically in the femur and below the knee, observed at ¹⁸F-NaF PET/CT. MATERIALS AND METHODS: One thousand consecutive PET/CT studies were retrospectively evaluated for the presence of exclusive uptake in lower extremities suggesting metastatic involvement. The presumptive diagnoses based on such uptakes were subsequently obtained by evaluation of other imaging studies. RESULTS: No exclusive uptake suggestive of metastasis below the femur was observed in the present series. Exclusive uptake was observed in the proximal femur with a presumptive diagnosis of metastasis in two patients. CONCLUSION: The prevalence of exclusive metastasis below the femur is low and scanning from head to knees is appropriate in most cases.

Keywords: PET/CT; ¹⁸F-NaF; Scintigraphy; Bone; Metastasis.