Background: The purpose of this work was to propose an approach based on noise measurement to adapt present clinical acquisition and reconstruction parameters adapted to a PMT-based system (Biograph mCT) to a SiPM-based system (Biograph Vision 450) sharing identical geometrical properties. The NEMA performance (NEMA) of the recently released Biograph Vision 450 PET/CT (Vision) was also derived. Methods: All measurements were conducted on Vision and Biograph mCT with TrueV (mCT). A full NEMA-based performance was derived for Vision only. The adaptation of acquisition and reconstruction parameters from mCT to Vision was done using the NEMA image quality phantom. The noise level reached using mCT was set as the reference value for six different numbers of net true coincidences. The noise level computed using Vision was matched to the reference noise level (within 0.01%) using a different reconstruction set-up to determine the potential reduction of count numbers for the same noise level. Results: Vision sensitivity was 9.1 kcps/MBq for a timing resolution of 213 ps at 5.3 kBq/mL. The NEMA-based CR for the 10-mm sphere was better than 75% regardless the reconstruction set-up studied. The mCT reference noise properties could be achieved using Vision with a scan time reduction (STR) of 1.34 with four iterations and a 440 × 440 matrix size (or STR = 1.89 with a 220 × 220 matrix size) together with a 3D CR improvement of 53% for the 10-mm sphere (24% using 220 × 220). Conclusion: The Vision exhibited improved NEMA performances compared to mCT. Using the proposed approach, the time acquisition could be divided by almost two, while keeping the same noise properties as that of mCT with a marked improvement of contrast recovery.