Bilateral simultaneous inferior petrosal sinus blood sampling for plasma ACTH measurements before and after CRH stimulation successfully confirmed the diagnosis of pituitary dependent Cushing's disease in 15 of 17 patients (88%) in whom this diagnosis was suspected on the basis of conventional biochemical testing. Magnetic resonance imaging, however, is superior to bilateral simultaneous inferior petrosal sinus blood sampling for the localization/lateralization of pituitary microadenomas in patients with Cushing's disease. Therefore, bilateral simultaneous inferior petrosal sinus blood sampling should be reserved for the assessment of those patients with Cushing's syndrome in whom either the results of biochemical tests are equivocal and/or subsequent pituitary magnetic resonance imaging gives unconvincing results.
This decrease of MIBI uptake in the mediastinal lymph nodes with therapy may imply that MIBI can be used to assess the response to treatment in sarcoidosis. Perhaps a relation exists between MIBI uptake at the moment of diagnosis and prognosis. Further studies in more patients are needed to evaluate the role of MIBI in the management of sarcoidosis.
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