{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:50:39Z","timestamp":1793325039752,"version":"4.5.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Clinician Scientist Programme on Rare Important Syndromes in Endocrinology"},{"name":"Else Kr\u00f6ner-Fresenius-Stiftung & Eva Luise und Horst K\u00f6hler Stiftung"},{"name":"DFG German Research Foundation Project","award":["314061271-TRR 205"],"award-info":[{"award-number":["314061271-TRR 205"]}]},{"name":"European Reference Network on Rare Endocrine Conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Bilateral inferior petrosal sinus sampling (BIPSS) is regarded as the gold standard to differentiate between Cushing\u00b4s disease (CD) and ectopic Cushing's syndrome (ECS). However, published data on the diagnostic value of additional prolactin analysis are controversial. Thus, we evaluated the diagnostic performance of BIPSS with and without prolactin in a multicenter study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and methods<\/jats:title>\n                    <jats:p>Retrospective study in five European reference centers. Patients with overt adrenocorticotropin (ACTH)-dependent Cushing's syndrome at the time of BIPSS with human corticotropin\u2013releasing hormone stimulation were eligible. Cut-offs for the inferior petrosal sinus (IPS) to peripheral (P) ACTH ratio and the normalized ACTH:prolactin IPS:P ratio were calculated via receiver operator characteristic analyses (reference: CD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>156 patients with BIPSS were identified. Of these, 120 patients (92 [77%] females; 106 [88%] CD, 14 [12%] ECS) had either histopathologically confirmed tumors or biochemical remission and\/or adrenal insufficiency after surgery; only this subgroup was analyzed by ROC analysis. The optimal cut-offs for the ACTH IPS:P ratio were \u22651.9 at baseline (sensitivity 82.1% [95% CI, 73.2-88.6], specificity 85.7% [95% CI, 56.2-97.5], AUC 0.86) and \u22652.1 at 5\u2005minutes post-CRH (sensitivity 91.3% [95% CI, 83.6-95.7], specificity 92.9% [95% CI, 64.1-99.6], AUC 0.96). A subgroup underwent additional prolactin analysis. An optimal cut-off of \u22651.4 was calculated for the normalized ACTH:prolactin IPS:P ratio (sensitivity 96.0% [95% CI, 77.7-99.9], specificity 100% [95% CI, 56.1-100], AUC 0.99).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study confirms the high accuracy of BIPSS in the differential diagnosis of ACTH-dependent Cushing's syndrome and suggests that the simultaneous measurement of prolactin might further improve the diagnostic performance of this test.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvad050","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T14:11:58Z","timestamp":1684419118000},"page":"448-456","source":"Crossref","is-referenced-by-count":32,"title":["Bilateral inferior petrosal sinus sampling with human CRH stimulation in ACTH-dependent Cushing's syndrome: results from a retrospective multicenter study"],"prefix":"10.1093","volume":"188","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1490-5575","authenticated-orcid":false,"given":"Mario","family":"Detomas","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Ritzel","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik IV, Klinikum der Universit\u00e4t M\u00fcnchen , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Nasi-Kordhishti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of T\u00fcbingen , T\u00fcbingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7972-7610","authenticated-orcid":false,"given":"Marie Helene","family":"Schernthaner-Reiter","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna , Vienna , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7810-8247","authenticated-orcid":false,"given":"Marco","family":"Losa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Istituto Scientifico San Raffaele, Vita-Salute University , Milano , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viola","family":"Tr\u00f6ger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Altieri","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Kroiss","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"},{"name":"Medizinische Klinik und Poliklinik IV, Klinikum der Universit\u00e4t M\u00fcnchen , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Kickuth","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6170-6398","authenticated-orcid":false,"given":"Martin","family":"Fassnacht","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Micko","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Graz , Graz , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7249-8077","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Honegger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of T\u00fcbingen , T\u00fcbingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9817-9875","authenticated-orcid":false,"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik IV, Klinikum der Universit\u00e4t M\u00fcnchen , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0586-0168","authenticated-orcid":false,"given":"Timo","family":"Deutschbein","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"},{"name":"Medicover Oldenburg MVZ , Oldenburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"key":"2023053110111003900_lvad050-B1","first-page":"281","article-title":"Cushing's syndrome: epidemiology and 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