ArticleJapanese journal of radiology2026
The usefulness of the follicle-preserving sign in differentiating between benign, borderline, and malignant ovarian tumors on magnetic resonance imaging.
Article in Japanese journal of radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Response to Dr. S Dhanya Dedeepya' s letter.Japanese journal of radiology · 2026Article
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6 authors.
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Abstract
purposeThe study aimed to evaluate the incidence and features of the follicle-preserving sign (FPS) and investigate its usefulness in differentiating the grades of malignancy of ovarian tumors using magnetic resonance imaging (MRI). MATERIALS AND
methodsThis retrospective study examined 234 patients of reproductive age with a confirmed diagnosis of ovarian lesions at Shinshu University Hospital between January 2014 and December 2023. Preoperative MR images of each patient were independently evaluated by two radiologists. First, 20 patients with malignant ovarian tumors were randomly selected. To define the MR findings of normal follicles, we observed the contralateral unaffected ovary. Next, the presence of FPS in the affected ovaries was examined in all patients. Finally, the FPS frequency was statistically analyzed in relation to patient age, maximum tumor diameter, tumor malignancy, MRI magnetic field strength, MRI slice thickness (MRIST), and histological subtype.
resultsAmong 276 ovarian lesions (benign, 146; borderline, 51; malignant, 79), the follicle-preserving sign (FPS) was significantly more frequent in benign tumors than in malignant tumors (p < 0.001), while no significant difference was observed between borderline tumors and the other two groups. Multivariate analysis identified patient age, tumor diameter, and MRIST as independent factors associated with FPS, with MRIST exerting the greatest influence (OR = 0.75, p = 0.006). Compared with malignant tumors, benign tumors tended to be smaller and were imaged with thinner slices, contributing to a higher FPS incidence. Importantly, even after stratification by MRIST, benign tumors consistently showed a significantly higher FPS rate than malignant tumors across all subgroups (p < 0.05). FPS frequency also varied by histological subtype, being frequent in serous/seromucinous borderline tumors and immature teratomas, but uncommon in mucinous tumors irrespective of malignancy status.
conclusionThe incidence of FPS was significantly higher in benign tumors than malignant tumors. However, it should be noted that FPS expression is affected by MRIST.
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