{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:52:30Z","timestamp":1791337950428,"version":"4.3.1"},"reference-count":45,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"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"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Testicular adrenal rest tumors (TART) frequently develop and are the most common cause of male infertility in classic congenital adrenal hyperplasia (CAH). Little is known about the natural course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to investigate age of onset and associated factors and characterize the sonographic natural history of TART in males with classic CAH followed prospectively from childhood to adulthood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Longitudinal study of clinical and hormonal data and serial scrotal ultrasounds performed every 6 months during childhood and annually in adulthood. Survival analysis and longitudinal models were used to determine age of TART onset and factors associated with TART progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven hundred eighty-three ultrasounds from 36 males were evaluated. Twenty-seven (75%) developed TART; the mean age of onset was 13.6 \u00b1 4.9 years, with \u223c22% risk before age 10. TART presence was associated with elevated ACTH, 17-hydroxyprogesterone, androstenedione, and plasma renin activity, younger age at diagnosis, salt-wasting (SW) phenotype, and null\/In2G mutations. Multivariable analysis revealed SW phenotype [odds ratio (OR): 6.83, 95% confidence interval (CI) 2.36-19.77; P &amp;lt; .001], treatment with higher hydrocortisone dose equivalents (OR: 1.10, 95% CI 1.03-1.18; P = .006), and elevated ACTH (OR: 1.0011, 95% CI 1.0005-1.0017; P &amp;lt; .01) increased risk of TART at any given visit. Of 19 patients with TART at last visit, the hydrocortisone dose equivalent was 16.0 \u00b1 7.9\u2005mg\/m2\/day, lower than 21.3 \u00b1 7.5\u2005mg\/m2\/day observed in patients whose TARTs resolved. Serial sonograms showed a characteristic pattern of TART progression from a single hypoechoic nodule to multiple hypoechoic nodules to a single conglomerate mass near the mediastinum testis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TART formation in CAH is frequently found in prepubertal boys, with a characteristic pattern of development resulting in a proposed radiologic staging. Pediatric screening is recommended, especially in those with a SW phenotype\/genotype.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf498","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T11:59:59Z","timestamp":1757073599000},"page":"698-706","source":"Crossref","is-referenced-by-count":10,"title":["Longitudinal Characterization and Sonographic Staging of Testicular Adrenal Rest Tumors"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5522-7666","authenticated-orcid":false,"given":"Sonal","family":"Vaid","sequence":"first","affiliation":[{"name":"NIH Clinical Center, National Institutes of Health , Bethesda, MD 20892-1932 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"NIH Clinical Center, National Institutes of Health , Bethesda, MD 20892-1932 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4281-0306","authenticated-orcid":false,"given":"Jamie","family":"Marko","sequence":"additional","affiliation":[{"name":"NIH Clinical Center, National Institutes of Health , Bethesda, MD 20892-1932 ,","place":["USA"]},{"name":"Department of Radiology and Radiological Science, Uniformed Services University of the Health Sciences , Bethesda, MD 20814-4799 ,","place":["USA"]},{"name":"American College of Radiology Institute for Radiologic Pathology , Silver Spring, MD 20910 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4045-1386","authenticated-orcid":false,"given":"Ninet","family":"Sinaii","sequence":"additional","affiliation":[{"name":"NIH Clinical Center, National Institutes of Health , Bethesda, MD 20892-1932 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5105-4475","authenticated-orcid":false,"given":"Charles","family":"Sukin","sequence":"additional","affiliation":[{"name":"NIH Clinical Center, National Institutes of Health , Bethesda, MD 20892-1932 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1743-7503","authenticated-orcid":false,"given":"Deepika","family":"Burkardt","sequence":"additional","affiliation":[{"name":"NIH Clinical Center, National Institutes of Health , Bethesda, MD 20892-1932 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Eustace","sequence":"additional","affiliation":[{"name":"NIH Clinical Center, National Institutes of Health , Bethesda, MD 20892-1932 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0637-4559","authenticated-orcid":false,"given":"Ashwini","family":"Mallappa","sequence":"additional","affiliation":[{"name":"NIH Clinical Center, National Institutes of Health , Bethesda, MD 20892-1932 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3746-0460","authenticated-orcid":false,"given":"Deborah P","family":"Merke","sequence":"additional","affiliation":[{"name":"NIH Clinical Center, National Institutes of Health , Bethesda, MD 20892-1932 ,","place":["USA"]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development , Bethesda, MD 20892 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"issue":"6","key":"2026021918525306800_dgaf498-B1","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1038\/s41574-022-00655-w","article-title":"Management challenges and therapeutic advances in congenital adrenal hyperplasia","volume":"18","author":"Mallappa","year":"2022","journal-title":"Nat Rev Endocrinol"},{"issue":"10108","key":"2026021918525306800_dgaf498-B2","doi-asserted-by":"crossref","first-page":"2194","DOI":"10.1016\/S0140-6736(17)31431-9","article-title":"Congenital adrenal hyperplasia","volume":"390","author":"El-Maouche","year":"2017","journal-title":"Lancet"},{"issue":"13","key":"2026021918525306800_dgaf498-B3","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1056\/NEJMra1909786","article-title":"Congenital adrenal hyperplasia due to 21-hydroxylase deficiency","volume":"383","author":"Merke","year":"2020","journal-title":"N Engl J Med"},{"issue":"11","key":"2026021918525306800_dgaf498-B4","doi-asserted-by":"crossref","first-page":"4043","DOI":"10.1210\/jc.2018-01865","article-title":"Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline","volume":"103","author":"Speiser","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026021918525306800_dgaf498-B5","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1210\/jc.2007-2417","article-title":"Approach to the adult with congenital adrenal hyperplasia due to 21-hydroxylase deficiency","volume":"93","author":"Merke","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"key":"2026021918525306800_dgaf498-B6","doi-asserted-by":"crossref","first-page":"624823","DOI":"10.1186\/1687-9856-2009-624823","article-title":"Testicular adrenal rest tumours in congenital adrenal hyperplasia","volume":"2009","author":"Claahsen-van der Grinten","year":"2009","journal-title":"Int J Pediatr Endocrinol"},{"issue":"9","key":"2026021918525306800_dgaf498-B7","doi-asserted-by":"crossref","first-page":"3674","DOI":"10.1210\/jc.2007-0337","article-title":"Testicular tumors in patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency show functional features of adrenocortical tissue","volume":"92","author":"Claahsen-van der Grinten","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"2026021918525306800_dgaf498-B8","doi-asserted-by":"crossref","first-page":"730947","DOI":"10.3389\/fendo.2021.730947","article-title":"Morphologic and molecular characterization of adrenals and adrenal rest affected by congenital adrenal hyperplasia","volume":"12","author":"Kolli","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"6","key":"2026021918525306800_dgaf498-B9","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1210\/js.2018-00082","article-title":"Extensive bilateral adrenal rest testicular tumors in a patient with 3\u03b2-hydroxysteroid dehydrogenase type 2 deficiency","volume":"2","author":"Lolis","year":"2018","journal-title":"J Endocr Soc"},{"issue":"1","key":"2026021918525306800_dgaf498-B10","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1210\/endrev\/bnab016","article-title":"Congenital adrenal hyperplasia-current insights in pathophysiology, diagnostics, and management","volume":"43","author":"Claahsen-van der Grinten","year":"2022","journal-title":"Endocr Rev"},{"issue":"3","key":"2026021918525306800_dgaf498-B11","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.fertnstert.2007.03.051","article-title":"Testicular adrenal rest tumors in patients with congenital adrenal hyperplasia can cause severe testicular damage","volume":"89","author":"Claahsen-van der Grinten","year":"2008","journal-title":"Fertil Steril"},{"issue":"3 Pt 2","key":"2026021918525306800_dgaf498-B12","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/j.juro.2016.09.072","article-title":"Testicular adrenal rest tumors in boys and young adults with congenital adrenal hyperplasia","volume":"197","author":"Kim","year":"2017","journal-title":"J Urol"},{"issue":"5","key":"2026021918525306800_dgaf498-B13","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1016\/j.juro.2017.11.122","article-title":"Re: testicular adrenal rest tumors in boys and young adults with congenital adrenal hyperplasia","volume":"199","author":"Verhees","year":"2018","journal-title":"J Urol"},{"issue":"5","key":"2026021918525306800_dgaf498-B14","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1210\/jcem-70-5-1408","article-title":"Steroidogenic enzyme activities, morphology, and receptor studies of a testicular adrenal rest in a patient with congenital adrenal hyperplasia","volume":"70","author":"Clark","year":"1990","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026021918525306800_dgaf498-B15","doi-asserted-by":"crossref","first-page":"E524","DOI":"10.1210\/jc.2014-2036","article-title":"Molecular characterization of testicular adrenal rest tumors in congenital adrenal hyperplasia: lesions with both adrenocortical and Leydig cell features","volume":"100","author":"Smeets","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2026021918525306800_dgaf498-B16","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1210\/jcem-23-9-861","article-title":"Activation of testicular adrenal rest tissue by prolonged excessive ACTH production","volume":"23","author":"Hamwi","year":"1963","journal-title":"J Clin Endocrinol Metab"},{"issue":"8","key":"2026021918525306800_dgaf498-B17","doi-asserted-by":"crossref","first-page":"2701","DOI":"10.1210\/jc.2016-3989","article-title":"11-oxygenated androgens are biomarkers of adrenal volume and testicular adrenal rest tumors in 21-hydroxylase deficiency","volume":"102","author":"Turcu","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026021918525306800_dgaf498-B18","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1093\/ejendo\/lvad143","article-title":"Hormonal control during infancy and testicular adrenal rest tumor development in males with congenital adrenal hyperplasia: a retrospective multicenter cohort study","volume":"189","author":"Schr\u00f6der","year":"2023","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2026021918525306800_dgaf498-B19","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1093\/ajcp\/77.4.501","article-title":"Massive hyperplasia of testicular adrenal rests in a patient with Nelson's syndrome","volume":"77","author":"Johnson","year":"1982","journal-title":"Am J Clin Pathol"},{"issue":"3","key":"2026021918525306800_dgaf498-B20","doi-asserted-by":"crossref","first-page":"705.e5","DOI":"10.1016\/j.fertnstert.2006.11.148","article-title":"Repeated successful induction of fertility after replacing hydrocortisone with dexamethasone in a patient with congenital adrenal hyperplasia and testicular adrenal rest tumors","volume":"88","author":"Claahsen-van der Grinten","year":"2007","journal-title":"Fertil Steril"},{"issue":"2","key":"2026021918525306800_dgaf498-B21","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1210\/jc.2016-2702","article-title":"Bilateral testicular tumors resulting in recurrent Cushing disease after bilateral adrenalectomy","volume":"102","author":"Puar","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2026021918525306800_dgaf498-B22","first-page":"1457","article-title":"Testicular adrenal rest tumors in congenital adrenal hyperplasia: study of a cohort of patients from a single Italian center","volume":"10","author":"Ortolano","year":"2023","journal-title":"Children (Basel)"},{"issue":"12","key":"2026021918525306800_dgaf498-B23","doi-asserted-by":"crossref","first-page":"5721","DOI":"10.1210\/jcem.86.12.8090","article-title":"High prevalence of testicular adrenal rest tumors, impaired spermatogenesis, and Leydig cell failure in adolescent and adult males with congenital adrenal hyperplasia","volume":"86","author":"Stikkelbroeck","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026021918525306800_dgaf498-B24","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1148\/radiology.198.1.8539414","article-title":"Testicular adrenal rest tissue in congenital adrenal hyperplasia: findings at Gray-scale and color Doppler US","volume":"198","author":"Avila","year":"1996","journal-title":"Radiology"},{"issue":"4","key":"2026021918525306800_dgaf498-B25","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1159\/000365570","article-title":"Increased prevalence of testicular adrenal rest tumours during adolescence in congenital adrenal hyperplasia","volume":"82","author":"Claahsen-van der Grinten","year":"2014","journal-title":"Horm Res Paediatr"},{"issue":"3","key":"2026021918525306800_dgaf498-B26","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1530\/EJE-07-0201","article-title":"Prevalence of testicular adrenal rest tumours in male children with congenital adrenal hyperplasia due to 21-hydroxylase deficiency","volume":"157","author":"Claahsen-van der Grinten","year":"2007","journal-title":"Eur J Endocrinol"},{"issue":"12","key":"2026021918525306800_dgaf498-B27","doi-asserted-by":"crossref","first-page":"4429","DOI":"10.1210\/jc.2012-2102","article-title":"Clinical characteristics of a cohort of 244 patients with congenital adrenal hyperplasia","volume":"97","author":"Finkielstain","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2026021918525306800_dgaf498-B28","doi-asserted-by":"crossref","first-page":"94","DOI":"10.4274\/jcrpe.563","article-title":"Testicular adrenal rest tumors in patients with congenital adrenal hyperplasia","volume":"4","author":"\u00c7akir","year":"2012","journal-title":"J Clin Res Pediatr Endocrinol"},{"issue":"12","key":"2026021918525306800_dgaf498-B29","doi-asserted-by":"crossref","first-page":"4583","DOI":"10.1210\/jc.2007-0383","article-title":"Testicular adrenal rest tumors and Leydig and Sertoli cell function in boys with classical congenital adrenal hyperplasia","volume":"92","author":"Martinez-Aguayo","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"issue":"7","key":"2026021918525306800_dgaf498-B30","doi-asserted-by":"crossref","first-page":"e2171","DOI":"10.1210\/clinem\/dgae824","article-title":"Adult height following prepubertal treatment with antiandrogen, aromatase inhibitor, and reduced hydrocortisone in CAH","volume":"110","author":"Merke","year":"2025","journal-title":"J Clin Endocrinol Metab"},{"key":"2026021918525306800_dgaf498-B31","doi-asserted-by":"crossref","first-page":"335","DOI":"10.3389\/fendo.2019.00335","article-title":"The high prevalence of testicular adrenal rest tumors in adult men with congenital adrenal hyperplasia is correlated with ACTH levels","volume":"10","author":"Mazzilli","year":"2019","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"11","key":"2026021918525306800_dgaf498-B32","doi-asserted-by":"crossref","first-page":"E1820","DOI":"10.1210\/jc.2012-3181","article-title":"Testicular adrenal rest tumors develop independently of long-term disease control: a longitudinal analysis of 50 adult men with congenital adrenal hyperplasia due to classic 21-hydroxylase deficiency","volume":"98","author":"Reisch","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2026021918525306800_dgaf498-B33","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1111\/eci.12426","article-title":"Chrousos syndrome: from molecular pathogenesis to therapeutic management","volume":"45","author":"Nicolaides","year":"2015","journal-title":"Eur J Clin Invest"},{"issue":"3","key":"2026021918525306800_dgaf498-B34","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1159\/000492082","article-title":"Prevalence of testicular adrenal rest tumor and factors associated with its development in congenital adrenal hyperplasia","volume":"90","author":"Mendes-Dos-Santos","year":"2018","journal-title":"Horm Res Paediatr"},{"issue":"6","key":"2026021918525306800_dgaf498-B35","doi-asserted-by":"crossref","first-page":"C3","DOI":"10.1530\/EJE-22-0784","article-title":"A new recipe for TARTs? One step closer in identifying the origin of testicular adrenal rest tumours","volume":"187","author":"Guasti","year":"2022","journal-title":"Eur J Endocrinol"},{"issue":"9","key":"2026021918525306800_dgaf498-B36","doi-asserted-by":"crossref","first-page":"986","DOI":"10.15537\/smj.2021.42.9.20210257","article-title":"Testicular adrenal rest tumors in children with congenital adrenal hyperplasia","volume":"42","author":"Al-Ghamdi","year":"2021","journal-title":"Saudi Med J"},{"issue":"10","key":"2026021918525306800_dgaf498-B37","first-page":"3535","article-title":"A preliminary study of flutamide, testolactone, and reduced hydrocortisone dose in the treatment of congenital adrenal hyperplasia","volume":"81","author":"Laue","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026021918525306800_dgaf498-B38","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1210\/jcem.85.3.6462","article-title":"Flutamide, testolactone, and reduced hydrocortisone dose maintain normal growth velocity and bone maturation despite elevated androgen levels in children with congenital adrenal hyperplasia","volume":"85","author":"Merke","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2026021918525306800_dgaf498-B39","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1210\/jc.2006-1311","article-title":"Testicular adrenal rest tumors in adult males with congenital adrenal hyperplasia: evaluation of pituitary-gonadal function before and after successful testis-sparing surgery in eight patients","volume":"92","author":"Claahsen-van der Grinten","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2026021918525306800_dgaf498-B40","doi-asserted-by":"crossref","first-page":"e2063","DOI":"10.1210\/clinem\/dgab051","article-title":"Modified-release hydrocortisone in congenital adrenal hyperplasia","volume":"106","author":"Merke","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026021918525306800_dgaf498-B41","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1093\/ejendo\/lvaf130","article-title":"Long-term outcomes in patients with congenital adrenal hyperplasia treated with hydrocortisone modified-release hard capsules","volume":"193","author":"Arlt","year":"2025","journal-title":"Eur J Endocrinol"},{"issue":"6","key":"2026021918525306800_dgaf498-B42","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1056\/NEJMoa2404656","article-title":"Phase 3 trial of Crinecerfont in adult congenital adrenal hyperplasia","volume":"391","author":"Auchus","year":"2024","journal-title":"N Engl J Med"},{"issue":"6","key":"2026021918525306800_dgaf498-B43","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1056\/NEJMoa2404655","article-title":"Phase 3 trial of Crinecerfont in pediatric congenital adrenal hyperplasia","volume":"391","author":"Sarafoglou","year":"2024","journal-title":"N Engl J Med"},{"issue":"Suppl 1","key":"2026021918525306800_dgaf498-B44","first-page":"A133","article-title":"12537 Once daily oral atumelnant (CRN04894) induces rapid and profound reductions of androstenedione and 17-hydroxyprogesterone in participants with classical congenital adrenal hyperplasia: initial results from a 12-week, phase 2, open-label study","volume":"8","author":"Auchus","year":"2024","journal-title":"J Endocr Soc"},{"issue":"4","key":"2026021918525306800_dgaf498-B45","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.2214\/ajr.172.4.10587136","article-title":"Testicular adrenal rest tissue in congenital adrenal hyperplasia: comparison of MR imaging and sonographic findings","volume":"172","author":"Avila","year":"1999","journal-title":"AJR Am J Roentgenol"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgaf498\/64224305\/dgaf498.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/3\/698\/64224305\/dgaf498.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/3\/698\/64224305\/dgaf498.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T23:53:06Z","timestamp":1771545186000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/111\/3\/698\/8249445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,8]]},"references-count":45,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9,8]]},"published-print":{"date-parts":[[2026,2,20]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgaf498","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2025,9,8]]}}}