Wondergem M, et al. - This paper resolved to discern the performance and clinical impact of both bone scintigraphy with ^99mTc-phosphonates (BS) and ¹⁸F-sodiumfluoride Positron Emission Tomography/computer tomography (NaF PET/CT) in primary staging of patients with prostate cancer. NaF PET/CT yielded better diagnostic performance than BS for the determination of bone metastases in the primary staging of prostate cancer patients. There appeared to be less equivocal findings with NaF PET/CT. NaF PET/CT exhibited additional value over BS as a result of the frequently encountered lymph node metastases.