{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T02:30:34Z","timestamp":1793154634659,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,7,10]],"date-time":"2012-07-10T00:00:00Z","timestamp":1341878400000},"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":[[2012,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Inferior petrosal sinus sampling (<jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content>) distinguishes pituitary\u2010dependent Cushing's disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>) from ectopic <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> syndrome with a high degree of certainty, but has not been reliable in predicting the location of an adenoma within the pituitary gland. We investigated whether prolactin measurements during <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content> would improve pituitary tumour localization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010four patients with suspected <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content>\u2010dependent Cushing's syndrome who underwent <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content> between 1997 and 2009 were studied retrospectively. Twenty\u2010eight patients who had an identifiable tumour that stained for <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> on histopathology are the subject of this study. Intersinus <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> gradients before and after adjustment for prolactin were compared with surgical findings and pathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Magnetic resonance imaging localized a pituitary adenoma in 17\/28 (61%) patients. Using a maximum intersinus <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> gradient of \u22651\u00b74 before or after <jats:styled-content style=\"fixed-case\">CRH<\/jats:styled-content> stimulation, we could diagnose the tumour location correctly in 15\/28 (54%) patients. By comparison, tumour lateralization by means of a dominant (\u22651\u00b74) prolactin\u2010adjusted <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> intersinus gradient was correct in 21\/28 (75%) patients (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7041). Tumour localization was correct in 23\/28 (82%) patients when <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> and prolactin\u2010adjusted ratio data were combined. Fourteen patients with proper bilateral <jats:styled-content style=\"fixed-case\">IPS<\/jats:styled-content> venous sampling (as determined by concurrent IPS to peripheral prolactin ratio \u22651\u00b78) either had correct localization of the tumour (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) or had a central lesion (<jats:italic>n<\/jats:italic>\u00a0=\u00a02). In none of these 14 patients was the dominant prolactin\u2010adjusted <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> ratio associated with a tumour on the opposite side of the gland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prolactin measurement, during <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content>, improves our ability to correctly localize the pituitary adenoma site in <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2265.2012.04339.x","type":"journal-article","created":{"date-parts":[[2012,1,13]],"date-time":"2012-01-13T19:53:07Z","timestamp":1326484387000},"page":"268-274","source":"Crossref","is-referenced-by-count":38,"title":["Prolactin measurement during inferior petrosal sinus sampling improves the localization of pituitary adenomas in Cushing's disease"],"prefix":"10.1111","volume":"77","author":[{"given":"Guy B.","family":"Mulligan","sequence":"first","affiliation":[{"name":"Departments of Endocrinology Diabetes and Metabolism The Neurological Institute The Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Faiman","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology Diabetes and Metabolism The Neurological Institute The Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjula","family":"Gupta","sequence":"additional","affiliation":[{"name":"Anatomic Pathology The Neurological Institute The Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology Diabetes and Metabolism The Neurological Institute The Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betul","family":"Hatipoglu","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology Diabetes and Metabolism The Neurological Institute The Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdinand","family":"Hui","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center The Neurological Institute The Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Weil","sequence":"additional","affiliation":[{"name":"Brain Tumor and Neuro\u2010Oncology Center The Neurological Institute The Cleveland Clinic  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir H.","family":"Hamrahian","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology Diabetes and Metabolism The Neurological Institute The Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,7,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198501103120207"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199109263251301"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1989.tb03737.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1726-4901(09)70293-X"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1096"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1440499"},{"key":"e_1_2_8_8_1","first-page":"690","article-title":"Adrenocorticotropic hormone\u2010dependent Cushing's syndrome: sensitivity and specificity of inferior petrosal sinus sampling","volume":"21","author":"Bonelli F.S.","year":"2000","journal-title":"AJNR. 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