INTRODUCTION: Our aim was to characterize the diagnostic accuracy indices for nodal (N)-staging with [ METHODS: In this prospective single center cross-over head-to-head comparative study 48 patients underwent [ RESULTS: TB and SAFOV PET/CT showed high diagnostic accuracy indices for patient-based N-staging. Sensitivity and specificity were 86.0% (CI: 77.0-95.0%) and 98.3% (CI: 97.3-99.3%) for TB
77.2% (CI: 66.3-88.1%) and 97.4% (CI: 96.1-98.6%) for SAFOV PET. Positive predictive value was higher for TB (81.7%, CI: 71.9-91.5%) compared to SAFOV PET (72.1%, CI: 60.9-83.4%). However, this finding was not statistically significant (p = 0.08). Negative predictive values for TB (98.6%, CI: 97.9-99.6%) and SAFOV PET/CT (98.0%, CI: 96.9-99.1%) were comparable. Overall, NSCLC N-staging was affected in six cases on SAFOV and only in one case on TB PET/CT. Semi-quantitative analysis revealed a threshold of SUV CONCLUSION: TB and SAFOV PET/CT showed high diagnostic accuracy indices for N-staging in NSCLC patients. Sensitivity and PPV on TB PET/CT were slightly higher, compared to SAFOV PET/CT without statistical significance. However, TB PET/CT showed lower rate of incorrect N-staging and lower semi-quantitative thresholds for the detection positive mediastinal lymph nodes. Therefore, TB PET/CT might be advantageous in detecting small and low [