{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T16:47:36Z","timestamp":1761238056845},"reference-count":23,"publisher":"The Endocrine Society","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,5,1]]},"abstract":"<jats:p>Inferior petrosal sinus sampling (IPSS) is used to distinguish pituitary Cushing\u2019s disease from occult cases of the ectopic ACTH syndrome, but is limited in that it requires the use of ovine CRH (oCRH) and is not highly accurate at predicting the intrapituitary location of tumors. This study was designed to determine whether cavernous sinus sampling (CSS) is as safe and accurate as IPSS, whether CSS can eliminate the need for oCRH stimulation, and whether CSS can accurately predict the intrapituitary location of tumors.<\/jats:p>\n               <jats:p>Ninety-three consecutive patients with ACTH-dependent Cushing\u2019s syndrome were prospectively studied with bilateral, simultaneous CSS before and after oCRH stimulation. Prediction of a pituitary or ectopic ACTH source was based on cavernous\/peripheral plasma ACTH ratios. Intrapituitary tumor location was predicted based on lateralization (side to side) ACTH ratios. These predictions were compared to surgical outcome in the 70 patients who had surgically proven pituitary (n= 65) or ectopic (n = 5) disease.<\/jats:p>\n               <jats:p>CSS distinguished pituitary Cushing\u2019s disease from the ectopic ACTH syndrome in 93% of patients with proven tumors before oCRH administration and in 100% of patients with proven tumors after oCRH. It was as safe and efficacious as published IPSS results. CSS accurately predicted the intrapituitary lateralization of the tumor in 83% of all patients and 89% of those patients with good catheter position and symmetric venous flow.<\/jats:p>\n               <jats:p>CSS is as safe and accurate as IPSS for distinguishing patients with pituitary Cushing\u2019s disease from those with the ectopic ACTH syndrome. In addition, CSS appears to be superior to IPSS for predicting intrapituitary tumor lateralization.<\/jats:p>","DOI":"10.1210\/jcem.84.5.5654","type":"journal-article","created":{"date-parts":[[2014,1,8]],"date-time":"2014-01-08T17:04:37Z","timestamp":1389200677000},"page":"1602-1610","source":"Crossref","is-referenced-by-count":7,"title":["Cavernous Sinus Sampling Is Highly Accurate in Distinguishing Cushing\u2019s Disease from the Ectopic Adrenocorticotropin Syndrome and in Predicting Intrapituitary Tumor Location1"],"prefix":"10.1210","volume":"84","author":[{"given":"Kathryn E.","family":"Graham","sequence":"first","affiliation":[{"name":"Division of Endocrinology (K.E.G., M.H.S., D.M.C., D.L.L.), Portland, Oregon 97201"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary H.","family":"Samuels","sequence":"additional","affiliation":[{"name":"Division of Endocrinology (K.E.G., M.H.S., D.M.C., D.L.L.), Portland, Oregon 97201"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary M.","family":"Nesbit","sequence":"additional","affiliation":[{"name":"Department of Radiology and Dotter Interventional Institute (G.M.N., S.L.B.), Portland, Oregon 97201"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Cook","sequence":"additional","affiliation":[{"name":"Division of Endocrinology (K.E.G., M.H.S., D.M.C., D.L.L.), Portland, Oregon 97201"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oisin R.","family":"O\u2019Neill","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (O.R.O., S.L.B.), Oregon Health Sciences University, Portland, Oregon 97201"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley L.","family":"Barnwell","sequence":"additional","affiliation":[{"name":"Department of Radiology and Dotter Interventional Institute (G.M.N., S.L.B.), Portland, Oregon 97201"},{"name":"Department of Neurosurgery (O.R.O., S.L.B.), Oregon Health Sciences University, Portland, Oregon 97201"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Lynn","family":"Loriaux","sequence":"additional","affiliation":[{"name":"Division of Endocrinology (K.E.G., M.H.S., D.M.C., D.L.L.), Portland, Oregon 97201"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","reference":[{"key":"2020071700281953600_R1","author":"Ross","year":"1982"},{"key":"2020071700281953600_R2","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1016\/S0025-6196(12)62142-9","article-title":"Diagnosis of corticotropin-producing bronchial carcinoid tumors causing Cushing\u2019s syndrome.","volume":"65","author":"Leinung","year":"1990","journal-title":"Mayo Clin Proc"},{"key":"2020071700281953600_R3","doi-asserted-by":"crossref","first-page":"211","DOI":"10.7326\/0003-4819-116-3-211","article-title":"Urine free cortisol in the high-dose dexamethasone suppression test for the differential diagnosis of the Cushing\u2019s syndrome.","volume":"116","author":"Flack","year":"1992","journal-title":"Ann Intern 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