دورية أكاديمية
Indication to dynamic and invasive testing in Cushing’s disease according to different neuroradiological findings
| العنوان: | Indication to dynamic and invasive testing in Cushing’s disease according to different neuroradiological findings |
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| المؤلفون: | Ferrante E., Barbot M., Serban A. L., Ceccato F., Carosi G., Lizzul L., Sala E., Daniele A., Indirli R., Cuman M., Locatelli M., Manara R., Arosio M., Boscaro M., Mantovani G., Scaroni C. |
| المساهمون: | Ferrante, E., Barbot, M., Serban, A. L., Ceccato, F., Carosi, G., Lizzul, L., Sala, E., Daniele, A., Indirli, R., Cuman, M., Locatelli, M., Manara, R., Arosio, M., Boscaro, M., Mantovani, G., Scaroni, C. |
| بيانات النشر: | Springer Science and Business Media Deutschland GmbH New York; USA |
| سنة النشر: | 2022 |
| المجموعة: | Sapienza Università di Roma: CINECA IRIS |
| مصطلحات موضوعية: | ACTH-dependent Cushing’s syndrome, bilateral inferior petrosal sinus sampling, Cushing’s disease, differential diagnosis |
| الوصف: | Purpose: Dynamic testing represents the mainstay in the differential diagnosis of ACTH-dependent Cushing’s syndrome. However, in case of undetectable or detectable lesion < 6mm on MRI, bilateral inferior petrosal sinus sampling (BIPSS) is suggested by current guidelines. Aim of this study was to analyze the performance of CRH, desmopressin and high-dose dexamethasone suppression test (HDDST) in the differential diagnosis of ACTH-dependent Cushing’s syndrome as well as the impact of invasive and noninvasive tests on surgical outcome in patients affected by Cushing’s disease (CD). Methods: Retrospective analysis on 148 patients with CD and 26 patients with ectopic ACTH syndrome. Results: Among CD patients, negative MRI/lesion < 6mm was detected in 97 patients (Group A); 29 had a 6–10mm lesion (Group B) and 22 a macroadenoma (Group C). A positive response to CRH test, HDSST and desmopressin test was recorded in 89.4%, 91·4% and 70.1% of cases, respectively. Concordant positive response to both CRH/HDDST and CRH/desmopressin tests showed a positive predictive value of 100% for the diagnosis of CD. Among Group A patients with concordant CRH test and HDDST, no difference in surgical outcome was found between patients who performed BIPSS and those who did not (66.6% vs 70.4%, p = 0.78). Conclusions: CRH, desmopressin test and HDDST have high accuracy in the differential diagnosis of ACTH-dependent CS. In patients with microadenoma < 6mm or non-visible lesion, a concordant positive response to noninvasive tests seems sufficient to diagnose CD, irrespective of MRI finding. In these patients, BIPSS should be reserved to discordant tests. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/34699044; info:eu-repo/semantics/altIdentifier/wos/WOS:000711308700001; volume:45; issue:3; firstpage:629; lastpage:637; numberofpages:9; journal:JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION; http://hdl.handle.net/11573/1615506Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85118143768 |
| DOI: | 10.1007/s40618-021-01695-1 |
| الإتاحة: | https://doi.org/10.1007/s40618-021-01695-1Test http://hdl.handle.net/11573/1615506Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.F1C39E61 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1007/s40618-021-01695-1 |
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