The application of artificial intelligence (AI) is accelerating the paradigm shift towards patient-tailored brain tumor management, achieving optimal onco-functional balance for each individual. AI-based models can positively impact different stages of the diagnostic and therapeutic process. Although the histological investigation will remain difficult to replace, in the near future the radiomic approach will allow a complementary, repeatable and non-invasive characterization of the lesion, assisting oncologists and neurosurgeons in selecting the best therapeutic option and the correct molecular target in chemotherapy. AI-driven tools are already playing an important role in surgical planning, delimiting the extent of the lesion (segmentation) and its relationships with the brain structures, thus allowing precision brain surgery as radical as reasonably acceptable to preserve the quality of life. Finally, AI-assisted models allow the prediction of complications, recurrences and therapeutic response, suggesting the most appropriate follow-up. Looking to the future, AI-powered models promise to integrate biochemical and clinical data to stratify risk and direct patients to personalized screening protocols.

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Disorders of sexual differentiation are rare congenital conditions in which the chromosomal, anatomic or gonadal sex development is atypical. In some of these patients, chromosomal sex is inconsistent with phenotypic sex; in other cases, the phenotype is not classifiable as either male or female, resulting in a condition known as ambiguous genitalia. These are very complex cases in which diagnostic certainty is not always possible. A multidisciplinary team including geneticists, pediatricians, radiologists is certainly needed to approach these patients. We present the case of an 18-year-old boy with an XY karyotype, ambiguous genitalia, uterus and blind-ending vaginal pouch. The patient had not been previously diagnosed with a disorder of sex development. The patient underwent a panel of genetic analyses and diagnostic imaging investigations. Magnetic resonance imaging was decisive for the identification of the internal genital organs, especially the uterus. At the end of investigations, the patient was diagnosed with 46,XY disorder of sex development. Our purpose is to underline the role of imaging in the diagnosis and management of congenital disorders of sex differentiation.

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Background/Aim: Despite the popularity of contrast enhanced spectral mammography (CESM), univocal classification of the background parenchymal enhancement (BPE), a bilateral enhancement of the normal breast parenchyma after contrast administration, is lacking. The present study aimed to evaluate the application of BPE Breast Imaging Reporting and Data System Magnetic Resonance (BI-RADS-MR) score for the CESM BPE. Moreover, a pictorial review of four different cases with CESM is provided. Patients and Methods: A single-center, retrospective study from a prospectively maintained database of all women undergoing digital mammography (DM) and CESM in our institution between 2016 and 2019. DM and CESM were classified by two experienced radiologists. Results: No statistically significant difference between DM breast density and BPE CESM classification was found. Agreement between readers ranged from substantial to almost perfect. Conclusion: BIRADS-RM score for the CESM BPE represents a handy option for radiologists with high inter-reader and DM agreement.Breast cancer (BC) is the leading cause of neoplasm affecting 2.1 million women per year worldwide (1). Despite the epidemiologic burden, deep knowledge of cancer biology, early detection and reduction of surgical impact have provided steady improvement in long term outcomes in the recent years (2-4).In Europe, early detection has been provided through mammographic screening programs, which alone provided reduction in morbidity related with locally advanced breast cancer (LABC) diagnosis, and cancer-specific mortality between 12% and 58% (5, 6), with reduction of locoregional lymph nodes involved (7, 8) and distant metastasis (9, 10).However, during screening when mammography is not sufficient, additional second level imaging such as digital breast tomosynthesis, ultrasound, magnetic resonance (MR) and/or contrast enhanced spectral mammography (CESM) are required (11).Within the last few years, CESM gained popularity as a diagnostic technique for BC detection. When compared with breast MR, CESM is a faster and cheaper technique, which is characterized by greater patients' comfort (12). Additionally, it has also been proven that CESM has a very low learning curve for imaging specialists (13).Thanks to these advantage, current CESM indication shifted from second level imaging alternative to MR in case of contraindication (e.g., patients with metallic prosthesis or claustrophobic) to evaluate inconclusive findings on mammography, and assess breast symptoms, cancer staging, and the response to neoadjuvant chemotherapy (12,14). Moreover, a recent use as an alternative examination to MR for high-risk screening has also been reported (13)(14)(15).Regarding the method, CESM can be performed using two different techniques, temporal subtraction (between pre-and post-contrast acquisition) and dual-energy subtraction. The latter one combines an iodinated contrast agent with dualenergy subtraction technique, consisting of a pair of lowenergy and high-energy images acquired after co...