Selective Venous Sampling to Differentiate Ectopic ACTH Secretion from Pituitary Cushing's Syndrome

ACTH Determination in a Petrosal Sinus Venous Specimen after Corticotrophin Releasing Factor Provides the Best Clue on the Laterality of Microadenoma in Cushing's Disease.

“…Early works on unilateral inferior petrosal sinus and jugular vein sampling (Corrigan et al, 1977;Findling et al, 1981;Drury et al, 1982) have emphasized the importance of bilateral simultaneous inferior petrosal venous sampling which should be performed if more reliance is to be placed on the results (Manni et al, 1983;Doppman et al, 1984;Oldfield et al, 1985;Zovickian et al, 1988). It has also been reported subsequently that bilateral inferior venous sampling may give rise to false negatives (Cuneo et al, 1985;Kageyama et al, 1985).…”

“…Selective venous sampling from the inferior petrosal sinus has been reported as a reliable and useful method to establish the presence and laterality of ACTH-secreting microadenomas (Corrigan et al, 1977;Findling et al, 1981;Drury et al, 1982;Manni et al, 1983;Doppman et al, 1984Zovickian et al, 1988). However, there is still uncertainty regarding the interpretation of the data obtained by this technique Cuneo et al, 1985;Kageyama et al, 1985;Ludeck 1988).…”

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

“…BIPSS as a diagnostic modality for Cushing syndrome was established in the 1970s. A case report in 1977 was the first to describe catheterization of and sampling of ACTH from the IPS to diagnose Cushing syndrome in a patient with perplexing clinical and laboratory features (35). This was followed by a case series in 1981 demonstrating the safety and efficacy of BIPSS in distinguishing Cushing syndrome from ectopic ACTH production, highlighting the importance of selecting the IPS, because measurements from the jugular veins were nondiagnostic (36).…”

The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease

“…12,38 Originally described by Corrigan and colleagues in 1977, 5 unilateral catheterization for selective venous sampling was introduced to differentiate ectopic ACTH secretion from pituitary Cushing's syndrome. Inferior petrosal sinus sampling is recommended in cases of Cushing's syndrome in which clinical, biochemical, or imaging studies have not clearly identified either a pituitary or an ectopic origin of the ACTH production.…”