Background: CEM-guided breast biopsy is an advanced diagnostic procedure that takes advantage of the ability of CEM to enhance suspicious breast lesions. The aim pf this paper is to describe a single-center retrospective experience on CEM-guided breast biopsy in terms of procedural features and histological outcomes. Methods: 69 patients underwent the procedure. Patient age, breast density, presentation, dimensions, and lesion target enhancement were recorded. All the biopsy procedures were performed using a 7- or 10-gauge (G) vacuum-assisted biopsy needle. The procedural approach (horizontal or vertical) and the decubitus of the patient (lateral or in a sitting position) were noted. Results: A total of 69 patients underwent a CEM-guided biopsy. Suspicious lesions presented as mass enhancement in 35% of cases and non-mass enhancement in 65% of cases. The median size of the target lesions was 20 mm. The median procedural time for each biopsy was 10 ± 4 min. The patients were placed in a lateral decubitus position in 52% of cases and seated in 48% of cases. The most common approach was horizontal (57%). The mean AGD was 14.8 mGy. At histology, cancer detection rate was 28% (20/71). Conclusions: CEM-guided biopsy was feasible, with high procedure success rates and high tolerance by the patients.

Objectives: To evaluate the correlation between radiomic features extracted from contrast-enhanced mammography (CEM) tumor lesions and peritumoral background with prognostic factors in breast cancer (BC). Methods: In this retrospective, single-center study, 134 women with histologically confirmed breast cancer underwent CEM examination. Radiomic features were extracted from manually segmented lesions and lesion contours were automatically delineated using PyRadiomics. The extracted features were categorized into seven classes: First-order Features, Shape Features (2D), Gray Level Co-occurrence Matrix (GLCM), Gray Level Run Length Matrix (GLRLM), Gray Level Size Zone Matrix (GLSZM), and Neighboring Gray Tone Difference Matrix (NGTDM). Histological examination assessed tumor type, grade, receptor structure (ER, PgR, HER2), Ki67 index, and lymph node involvement. Pearson correlation and multivariate regression were applied to evaluate associations between radiomic features and prognostic factors. Results: Significant correlations were found between First-order Features and prognostic factors such as ER, PgR, and Ki67 (p < 0.05). GLCM-based texture features showed strong associations with Ki67 and HER2 (p < 0.01). Radiomic features from peritumoral regions, especially shape and GLSZM metrics, were significantly correlated with Ki67 and lymph node involvement. Conclusions: Radiomic analysis of both tumor and peritumoral regions offers significant insights into BC prognosis. These findings support the integration of radiomics into personalized diagnostic and therapeutic strategies, potentially improving clinical decision making in BC management.

A vertebral compression fracture (VCF) is a pathological condition, which can be caused by osteoporotic degeneration or metastatic disease. It represents a socioeconomic burden on healthcare systems, due to increased pain, long-term morbidity, and disability. Vertebroplasty (VP) is an image-guided, minimally invasive, interventional procedure, in which bone cement is injected via a percutaneous approach into the vertebral soma, to provide structural support and to stabilize the weakened structure. The aim of this narrative review is to describe vertebral column biomechanics, as well as indications, contraindications, and techniques to successfully perform VP for the treatment of VCFs. Methods: We performed a narrative literature review on the main online databases regarding VP, and mainly focused on patient selection, preoperative imaging, procedural steps, complications, and outcomes. Results: The most recent evidence in the literature has shown that VP provides significant and sustained clinical benefits for patients with a VCF, and it is indicated in patients with comorbidities that make prolonged bed rest dangerous, patients with fractures that fail to heal, and as palliation in patients with a painful VCF due to metastatic disease. Conclusions: VP is considered to be a safe and effective treatment option for the treatment of osteoporotic and malignant VCFs that are resistant to adequate medical therapy. Patient selection, preprocedural evaluation, and proper technique execution are the key points to obtain the best outcomes and to minimize complications.