Inferior Petrosal Sampling for the Differential Diagnosis of ACTH-Dependent Cushing’s Syndrome

Javorsky, Bradley R.; Findling, James W.

doi:10.1007/978-1-60327-449-4_9

Cited by 17 publications

(34 citation statements)

References 68 publications

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“…Baseline IPS/P≥2 or CRHstimulated IPS/P≥3 confirms Cushing syndrome (22). False-negative rates for BIPSS range from 1% to 10%.…”

Section: Technical Details and Considerationsmentioning

confidence: 93%

“…We then administer 3 000-5 000 units of heparin. In addition to refraining from cannulating the IPS too centrally, heparin administration is important to avoid IPS and cavernous sinus thrombosis (22).…”

Section: Technical Details and Considerationsmentioning

confidence: 99%

“…False-negative rates for BIPSS range from 1% to 10%. Such cases can be further evaluated by normalizing the ratio to prolactin levels, which must be measured at the time of BIPSS in a similar manner to what has been described elsewhere (22).…”

Section: Technical Details and Considerationsmentioning

confidence: 99%

“…There is general consensus that BIPSS is indicated only once ACTH-dependent hypercortisolemia has been firmly established (13,22). In other words, BIPSS is not meant to diagnose Cushing syndrome, but to diagnose a pituitary source of ACTH hypersecretion.…”

Section: Accuracy and Utilitymentioning

confidence: 99%

“…If these noninvasive tests fail to distinguish Cushing syndrome from ectopic ACTH secretion or if they provide equivocal or ambiguous results, BIPSS with CRH stimulation is indicated for further evaluation (22).…”

mentioning

confidence: 99%

See 4 more Smart Citations

The role of bilateral inferior petrosal sinus sampling in the diagnostic evaluation of cushing’s disease

Deipolyi

Karaosmanoğlu

Habito

et al. 2011

Diagn Interv Radiol

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“…Baseline IPS/P≥2 or CRHstimulated IPS/P≥3 confirms Cushing syndrome (22). False-negative rates for BIPSS range from 1% to 10%.…”

Section: Technical Details and Considerationsmentioning

confidence: 93%

Section: Technical Details and Considerationsmentioning

confidence: 99%

Section: Technical Details and Considerationsmentioning

confidence: 99%

Section: Accuracy and Utilitymentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

The role of bilateral inferior petrosal sinus sampling in the diagnostic evaluation of cushing’s disease

Deipolyi

Karaosmanoğlu

Habito

et al. 2011

Diagn Interv Radiol

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Selective Venous Sampling for Hypercortisolism

Solander

2022

Diagnosis and Management of Endocrine Disorders in Interventional Radiology

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Diagnostic accuracy of Bilateral Inferior Petrosal Sinus Sampling: The Experience of a Tertiary Centre

Pereira

Ferreira

Amaral

et al. 2019

Exp Clin Endocrinol Diabetes

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Purpose To assess the accuracy of bilateral inferior petrosal sinus sampling both in the differential diagnosis of adrenocorticotrophic hormone dependent Cushing’s syndrome and predicting the localization on the pituitary. Methods The authors evaluated all patients that undergone bilateral inferior petrosal sinus sampling in a tertiary centre, between January 1995 and March 2018. The probable diagnosis of Cushing’s disease was made when the basal central/peripheral gradient was>2 and/or>3 after stimulation with corticotrophin releasing hormone. The localization was suggested when the inter-sinus gradient was>1.4. The results obtained were compared with the post operatory results: compatible histology and positive immunohistochemistry to adrenocorticotrophic hormone and/or the presence of criteria of cure. Sensitivity, specificity and predictive positive value were calculated. Results A total of 49 patients were evaluated (75.5% female; mean age 45.4±16.3 years old). Bilateral inferior petrosal sinus sampling was compatible with Cushing’s disease in 27 out of 28 confirmed cases in histology or by criteria of cure, and was compatible with ectopic secretion in the 2 cases confirmed as ectopic secretion of adrenocorticotrophic hormone (sensitivity 96.4%; specificity 100%). The lateralization calculated was concordant with the results after surgery in 17 out of 27 patients with Cushing’s disease – predictive positive value of 63%. Magnetic resonance had a higher predictive value to lateralization – 70.0%. Conclusions Bilateral inferior petrosal sinus sampling is a safe and reliable procedure to diagnose Cushing’s disease, with great sensitivity and specificity. Nevertheless, the capacity of this procedure to lateralize the lesion inside the pituitary is limited.

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Inferior Petrosal Sampling for the Differential Diagnosis of ACTH-Dependent Cushing’s Syndrome

Cited by 17 publications

References 68 publications

The role of bilateral inferior petrosal sinus sampling in the diagnostic evaluation of cushing’s disease

The role of bilateral inferior petrosal sinus sampling in the diagnostic evaluation of cushing’s disease

Selective Venous Sampling for Hypercortisolism

Diagnostic accuracy of Bilateral Inferior Petrosal Sinus Sampling: The Experience of a Tertiary Centre

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