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The spiculation analysis could be used as a non-invasive method providing information about malignant lesions. The tumor proliferative activity, and therefore the patient's prognosis, might be predicted before biopsy directly from DBT images. The spiculation analysis could be used as a non-invasive method providing information about malignant lesions. The tumor proliferative activity, and therefore the patient's prognosis, might be predicted before biopsy directly from DBT images.Neuroendocrine tumors (NET) are a rare and heterogeneous