Please consider F-18 NaF at least as a bone scanning agent for the extremely obese, exactly for the same reasons Rb-82 RbCl and N-13 NH3 are generally accepted for myocardial perfusion testing in the obese f.e. by Aetna and Anthem, see http://www.aetna.com/cpb/medical/data/1_99/0071.html and http://www.anthem.com/medicalpolicies/policies/mp_pw_a050587.htm