ECE2016 Eposter Presentations Neuroendocrinology (43 abstracts)
Assessment of bilateral inferior petrosal sinus sampling in the differential diagnosis of the ACTH-Dependent cushing’s syndrome
Paloma Moreno-Moreno 1 , Inmaculada Prior-Sánchez 1 , Elvira Jiménez-Gómez 2 , Jose Carlos Padillo-Cuenca 1 , Fernándo Delgado-Acosta 2 , Rafael Oteros-Fernández 2 , María Sierra Corpas-Jiménez 1 & María Ángeles Gálvez-Moreno 1
1Management Unit of Clinical Endocrinology and Nutrition. University Hospital Reina Sofía, Córdoba, Spain; 2Management Unit of Clinical Radiology. University Hospital Reina Sofía, Córdoba, Spain.
Objective: The aim of this study was to assess the diagnostic accuracy of BIPSS with desmopressin stimulation in the differential diagnosis of ACTH-dependent Cushing’s syndrome.
Patients and methods: Retrospective study of patients studied to our hospital for diagnosis of ACTH-dependent Cushing’s syndrome (2000–2015). The histopathological results in patients who underwent a surgical procedure was considered the reference for statistical study of the accuracy of this technique. Statistical analysis: rates of assessment of diagnostic tests and Cohen’s kappa coefficient as a measure of interrater agreement between two observations.
Results: BIPSS was performed in 31 patients, of these, 24 patients were operated: 79.2% Cushing’s disease (CD), 8.3% ectopic Cushing’s syndrome and 12.5% adrenal Cushing’s syndrome. 84% of patients with CD had a central positive location in BIPSS (Sensitivity: 0.84, IC 95%: 0.67–1.00); 100% of patients without CD had a negative BIPSS for the central location (Specificity: 1.00, IC 95%: 1.00–1.00), 100% of patients with BIPSS positive for central location were diagnosed of CD (Positive Predictive Value: 1.00, IC 95%: 1.00–1.00), 63% patients with BIPSS negative for central location weren’t diagnosed of CD (Negative Predictive Value: 0.63, IC 95%: 0,29–0,96). 88% of patients were correctly classified after BIPSS (Efficiency: 0.88, IC 95%: 0.74–1.00). Good agreement is observed between the location of pituitary magnetic resonance (MRI) or computed tomography (CT) and BIPSS (K=0.625; P=0.002).
Conclusions: BIPSS with desmopressin stimulation is useful in the differential diagnosis of ACTH-dependent Cushing’s syndrome, and it shows good agreement with imaging tests used.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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