{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:21:11Z","timestamp":1787494871928,"version":"build-2736575974"},"reference-count":35,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","theclinics.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Endocrinology and Metabolism Clinics of North America"],"published-print":{"date-parts":[[2025,12]]},"DOI":"10.1016\/j.ecl.2025.06.001","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T03:47:03Z","timestamp":1753415223000},"page":"537-548","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnosis of Cushing\u2019s Disease"],"prefix":"10.1016","volume":"54","author":[{"given":"Henrik","family":"Elenius","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynnette K.","family":"Nieman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"2","key":"10.1016\/j.ecl.2025.06.001_bib1","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1001\/jama.2023.11305","article-title":"Cushing syndrome: a review","volume":"330","author":"Reincke","year":"2023","journal-title":"JAMA"},{"issue":"5","key":"10.1016\/j.ecl.2025.06.001_bib2","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1210\/jc.2008-0125","article-title":"The diagnosis of cushing\u2019s syndrome: an endocrine society clinical practice guideline","volume":"93","author":"Nieman","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"10.1016\/j.ecl.2025.06.001_bib3","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1007\/s12020-013-0013-0","article-title":"Update on late-night salivary cortisol for the diagnosis of Cushing\u2019s syndrome: methodological considerations","volume":"44","author":"Raff","year":"2013","journal-title":"Endocrine"},{"issue":"6","key":"10.1016\/j.ecl.2025.06.001_bib4","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1530\/EJE-09-0046","article-title":"The prevalence and characteristic features of cyclicity and variability in Cushing\u2019s disease","volume":"160","author":"Alexandraki","year":"2009","journal-title":"Eur J Endocrinol"},{"issue":"5","key":"10.1016\/j.ecl.2025.06.001_bib5","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/s11102-024-01458-0","article-title":"Differential diagnosis between Cushing\u2019s syndrome and non-neoplastic hypercortisolism: are we getting there?","volume":"27","author":"Pivonello","year":"2024","journal-title":"Pituitary"},{"key":"10.1016\/j.ecl.2025.06.001_bib6","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2023.1158573","article-title":"Distinct serum steroid profiles between adrenal Cushing syndrome and Cushing disease","volume":"14","author":"Gao","year":"2023","journal-title":"Front Endocrinol"},{"issue":"3","key":"10.1016\/j.ecl.2025.06.001_bib7","doi-asserted-by":"crossref","first-page":"297","DOI":"10.3803\/EnM.2015.30.3.297","article-title":"Limited diagnostic utility of plasma adrenocorticotropic hormone for differentiation between adrenal cushing syndrome and cushing disease","volume":"30","author":"Hong","year":"2015","journal-title":"Endocrinol Metab (Seoul)"},{"issue":"7","key":"10.1016\/j.ecl.2025.06.001_bib8","first-page":"1057","article-title":"The ectopic ACTH syndrome","volume":"25","author":"Liddle","year":"1965","journal-title":"Cancer Res"},{"key":"10.1016\/j.ecl.2025.06.001_bib9","first-page":"283","article-title":"Clinical and laboratory studies of ectopic humoral syndromes","volume":"25","author":"Liddle","year":"1969","journal-title":"Recent Prog Horm Res"},{"issue":"2","key":"10.1016\/j.ecl.2025.06.001_bib10","doi-asserted-by":"crossref","DOI":"10.1210\/jendso\/bvae194","article-title":"Recognition and management of ectopic ACTH secreting tumors","volume":"9","author":"Elenius","year":"2025","journal-title":"J Endocr Soc"},{"issue":"12","key":"10.1016\/j.ecl.2025.06.001_bib11","first-page":"3617","article-title":"11 beta-Hydroxysteroid dehydrogenase activity in Cushing\u2019s syndrome: explaining the mineralocorticoid excess state of the ectopic adrenocorticotropin syndrome","volume":"80","author":"Stewart","year":"1995","journal-title":"J Clin Endocrinol Metab"},{"issue":"11","key":"10.1016\/j.ecl.2025.06.001_bib12","doi-asserted-by":"crossref","first-page":"2882","DOI":"10.1210\/clinem\/dgae258","article-title":"Personalized noninvasive diagnostic algorithms based on urinary free cortisol in ACTH-dependant cushing's syndrome","volume":"109","author":"Lavoillotte","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"10.1016\/j.ecl.2025.06.001_bib13","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.tem.2023.12.003","article-title":"A clinical perspective on ectopic Cushing\u2019s syndrome","volume":"35","author":"Ragnarsson","year":"2024","journal-title":"Trends Endocrinol Metab"},{"issue":"1","key":"10.1016\/j.ecl.2025.06.001_bib14","doi-asserted-by":"crossref","DOI":"10.1016\/j.beem.2021.101521","article-title":"Epidemiology and mortality of Cushing\u2019s syndrome","volume":"35","author":"Hakami","year":"2021","journal-title":"Best Pract Res Clin Endocrinol Metabol"},{"issue":"4","key":"10.1016\/j.ecl.2025.06.001_bib15","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1093\/ejendo\/lvad008","article-title":"Cushing\u2019s syndrome in the elderly: data from the European Registry on Cushing\u2019s syndrome","volume":"188","author":"Amodru","year":"2023","journal-title":"Eur J Endocrinol"},{"issue":"3","key":"10.1016\/j.ecl.2025.06.001_bib16","doi-asserted-by":"crossref","first-page":"311","DOI":"10.3174\/ajnr.A7789","article-title":"MRI for cushing disease: a systematic review","volume":"44","author":"Castle-Kirszbaum","year":"2023","journal-title":"AJNR Am J Neuroradiol"},{"issue":"3","key":"10.1016\/j.ecl.2025.06.001_bib17","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s12020-016-1038-y","article-title":"Pituitary magnetic resonance imaging in Cushing\u2019s disease","volume":"55","author":"Vitale","year":"2017","journal-title":"Endocrine"},{"issue":"5","key":"10.1016\/j.ecl.2025.06.001_bib18","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/s11102-022-01236-w","article-title":"Modern imaging in Cushing\u2019s disease","volume":"25","author":"Bashari","year":"2022","journal-title":"Pituitary"},{"issue":"10","key":"10.1016\/j.ecl.2025.06.001_bib19","doi-asserted-by":"crossref","first-page":"817","DOI":"10.7326\/0003-4819-120-10-199405150-00001","article-title":"Pituitary magnetic resonance imaging in normal human volunteers: occult adenomas in the general population","volume":"120","author":"Hall","year":"1994","journal-title":"Ann Intern Med"},{"issue":"1","key":"10.1016\/j.ecl.2025.06.001_bib20","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.ecl.2007.10.011","article-title":"Nonfunctioning pituitary tumors and pituitary incidentalomas","volume":"37","author":"Molitch","year":"2008","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"5","key":"10.1016\/j.ecl.2025.06.001_bib21","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1530\/eje.1.02107","article-title":"Subclinical adenomas in postmortem pituitaries: classification and correlations to clinical data","volume":"154","author":"Buurman","year":"2006","journal-title":"Eur J Endocrinol"},{"issue":"13","key":"10.1016\/j.ecl.2025.06.001_bib22","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1056\/NEJM199109263251301","article-title":"Petrosal sinus sampling with and without corticotropin-releasing hormone for the differential diagnosis of Cushing\u2019s syndrome","volume":"325","author":"Oldfield","year":"1991","journal-title":"N Engl J Med"},{"issue":"1","key":"10.1016\/j.ecl.2025.06.001_bib23","doi-asserted-by":"crossref","first-page":"e182","DOI":"10.1210\/clinem\/dgad454","article-title":"Ovine CRH stimulation and 8 mg dexamethasone suppression tests in 323 patients with ACTH-dependent cushing's syndrome","volume":"109","author":"Elenius","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"10.1016\/j.ecl.2025.06.001_bib24","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/s11102-019-00965-9","article-title":"Ectopic cushing\u2019s syndrome due to corticotropin releasing hormone","volume":"22","author":"Nakhjavani","year":"2019","journal-title":"Pituitary"},{"issue":"2","key":"10.1016\/j.ecl.2025.06.001_bib25","first-page":"533","article-title":"The hypoplastic inferior petrosal sinus: a potential source of false-negative results in petrosal sampling for Cushing\u2019s disease","volume":"84","author":"Doppman","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"10.1016\/j.ecl.2025.06.001_bib26","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/s11154-022-09723-y","article-title":"Diagnostic accuracy of bilateral inferior petrosal sinus sampling using desmopressin or corticotropic- releasing hormone in ACTH-dependent Cushing\u2019s syndrome: a systematic review and meta-analysis","volume":"23","author":"Valizadeh","year":"2022","journal-title":"Rev Endocr Metab Disord"},{"key":"10.1016\/j.ecl.2025.06.001_bib27","doi-asserted-by":"crossref","first-page":"e712","DOI":"10.1016\/j.wneu.2023.12.024","article-title":"Inferior petrosal sinus sampling tumor lateralization and the surgical treatment of cushing disease: a meta-analysis and systematic review","volume":"182","author":"Webb","year":"2024","journal-title":"World Neurosurg"},{"issue":"12","key":"10.1016\/j.ecl.2025.06.001_bib28","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/S2213-8587(21)00235-7","article-title":"Consensus on diagnosis and management of Cushing\u2019s disease: a guideline update","volume":"9","author":"Fleseriu","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"5","key":"10.1016\/j.ecl.2025.06.001_bib29","doi-asserted-by":"crossref","first-page":"R201","DOI":"10.1530\/EJE-18-0007","article-title":"Diagnosis of endocrine disease: the role of the desmopressin test in the diagnosis and follow-up of Cushing\u2019s syndrome","volume":"178","author":"Vassiliadi","year":"2018","journal-title":"Eur J Endocrinol"},{"issue":"5","key":"10.1016\/j.ecl.2025.06.001_bib30","first-page":"1768","article-title":"Vasopressin receptor expression and mutation analysis in corticotropin-secreting tumors","volume":"81","author":"Dahia","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"issue":"8","key":"10.1016\/j.ecl.2025.06.001_bib31","doi-asserted-by":"crossref","DOI":"10.1111\/jne.13186","article-title":"Long-term follow-up and predictors of recurrence of Cushing\u2019s disease","volume":"34","author":"Guignat","year":"2022","journal-title":"J Neuroendocrinol"},{"issue":"Suppl 2","key":"10.1016\/j.ecl.2025.06.001_bib32","doi-asserted-by":"crossref","first-page":"A528","DOI":"10.1210\/jendso\/bvac150.1100","article-title":"PMON102 utility of the desmopressin stimulation test to detect cyclic cushing\u2019s disease","volume":"6","author":"Elenius","year":"2022","journal-title":"J Endocr Soc"},{"issue":"7","key":"10.1016\/j.ecl.2025.06.001_bib33","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1507\/endocrj.EJ20-0837","article-title":"The usefulness of the combined high-dose dexamethasone suppression test and desmopressin stimulation test in establishing the source of ACTH secretion in ACTH-dependent Cushing\u2019s syndrome","volume":"68","author":"Qiao","year":"2021","journal-title":"Endocr J"},{"issue":"3","key":"10.1016\/j.ecl.2025.06.001_bib34","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s40618-021-01695-1","article-title":"Indication to dynamic and invasive testing in Cushing\u2019s disease according to different neuroradiological findings","volume":"45","author":"Ferrante","year":"2022","journal-title":"J Endocrinol Investig"},{"issue":"5","key":"10.1016\/j.ecl.2025.06.001_bib35","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1007\/s11102-016-0729-y","article-title":"Second-line tests in the differential diagnosis of ACTH-dependent Cushing\u2019s syndrome","volume":"19","author":"Barbot","year":"2016","journal-title":"Pituitary"}],"container-title":["Endocrinology and Metabolism Clinics of North America"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S088985292500057X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S088985292500057X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T15:33:38Z","timestamp":1761147218000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S088985292500057X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["S088985292500057X"],"URL":"https:\/\/doi.org\/10.1016\/j.ecl.2025.06.001","relation":{},"ISSN":["0889-8529"],"issn-type":[{"value":"0889-8529","type":"print"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Diagnosis of Cushing\u2019s Disease","name":"articletitle","label":"Article Title"},{"value":"Endocrinology and Metabolism Clinics of North America","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ecl.2025.06.001","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}