The role of inferior petrosal sinus sampling in ACTH-dependent Cushing's syndrome: Review and joint opinion statement by members of the Italian Society for Endocrinology, Italian Society for Neurosurgery, and Italian Society for Neuroradiology

Francesca Pecori Giraldi, Luigi Maria Cavallo, Fabio Tortora, Rosario Pivonello, Annamaria Colao, Paolo Cappabianca, Franco Mantero

Research output: Contribution to journalArticlepeer-review

Abstract

In the management of adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome, inferior petrosal sinus sampling (IPSS) provides information for the endocrinologist, the neurosurgeon, and the neuroradiologist. To the endocrinologist who performs the etiological diagnosis, results of IPSS confirm or exclude the diagnosis of Cushing's disease with 80%-100% sensitivity and over 95% specificity. Baseline central-peripheral gradients have suboptimal accuracy, and stimulation with corticotropin-releasing hormone (CRH), possibly desmopressin, has to be performed. The rationale for the use of IPSS in this context depends on other diagnostic means, taking availability of CRH and reliability of dynamic testing and pituitary imaging into account. As regards the other specialists, the neuroradiologist may collate results of IPSS with findings at imaging, while IPSS may prove useful to the neurosurgeon to chart a surgical course. The present review illustrates the current standpoint of these 3 specialists on the role of IPSS.

Original languageEnglish
Article numberE5
JournalNeurosurgical Focus
Volume38
Issue number2
DOIs
Publication statusPublished - 2015

Keywords

  • Cushing's disease
  • Cushing's syndrome
  • Diagnosis
  • Inferior petrosal sinus sampling
  • Pituitary adenoma
  • Pituitary imaging
  • Pituitary surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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