{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:56:48Z","timestamp":1785254208817,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,27]],"date-time":"2017-11-27T00:00:00Z","timestamp":1511740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bilateral inferior petrosal sinus sampling (<jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content>) with corticotropin\u2010releasing hormone (<jats:styled-content style=\"fixed-case\">CRH<\/jats:styled-content>) is currently the gold standard in the diagnosis of Cushing's disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>) and has also been used in tumour lateralization. Our objective was to determine the diagnostic value and lateralization accuracy of <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content> with desmopressin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analysed 91 patients with Cushing's syndrome who had either negative findings on pituitary dynamic enhanced magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) or nonsuppressed high\u2010dose dexamethasone suppression tests (<jats:styled-content style=\"fixed-case\">HDDST<\/jats:styled-content>). Thin\u2010slice thoracoabdominal computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>) and octreotide receptor imaging of whole body were also negative to rule out ectopic adrenocorticotropin hormone (<jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content>) syndrome. All patients went through <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content> with desmopressin. Afterwards, transsphenoidal pituitary surgery, light microscope pathology and immunohistological staining for <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> were performed in all patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>Diagnosis of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content><\/jats:italic>. Among the 91 patients included, 90 were confirmed with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>, of whom 89 had positive <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content> findings, therefore the sensitivity was 98.9%. The one patient who was negative for <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> also had negative <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content> findings, therefore the specificity was 100%. <jats:italic>Tumour lateralization<\/jats:italic>. Among the 51 patients who were ultimately diagnosed with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> and whose lateralization by <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content> and surgery was either left or right, 37 had <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content> lateralization in concordance with surgery, therefore the concordance rate was 72.5%. Patients in the concordant group had a higher frequency of right lateralization by surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content> with desmopressin is a sensitive approach in the diagnosis of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> and has moderate accuracy in tumour lateralization, making it an alternative choice to <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">CRH<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13505","type":"journal-article","created":{"date-parts":[[2017,10,28]],"date-time":"2017-10-28T15:32:38Z","timestamp":1509204758000},"page":"251-257","source":"Crossref","is-referenced-by-count":32,"title":["Tumour lateralization in Cushing's disease by inferior petrosal sinus sampling with 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