ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume : 14 Issue : 1 Year : 2022
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Turkish Society for Pediatric Endocrinology and Diabetes
Diagnostic Value of Bilateral Petrosal Sinus Sampling in Children with Cushing Disease: A Multi-center Study [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2022; 14(1): 29-36 | DOI: 10.4274/jcrpe.galenos.2021.2021.0152

Diagnostic Value of Bilateral Petrosal Sinus Sampling in Children with Cushing Disease: A Multi-center Study

Hande Turan1, Gönül Çatlı2, Aslı Derya Kardelen3, Ece Böber4, Ayşehan Akıncı5, Semra Çetinkaya6, Özgecan Demirbaş7, Eren Er8, Saadet Olcay Evliyaoğlu1, Bumin Dündar2, Oya Ercan1
1İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
2İzmir Kâtip Çelebi University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
3İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
4Dokuz Eylül University Faculty of Medicine, Department of Endocrinology, İzmir, Turkey
5İnönü University Faculty of Medicine, Department of Pediatric Endocrinology, Malatya, Turkey
6University of Health Sciences Turkey, Dr. Sami Ulus Obstetrics and Gynecology, Child Health and Diseases, Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
7Bursa Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
8Ege University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey

INTRODUCTION: Although the sensitivity and specificity of bilateral inferior petrosal sinus sampling (BIPSS) were shown to be quite high in adult patients, pediatric studies are limited in number and have conflicting results, since BIPSS is much less commonly performed in children. The aim of this study was to assess the role of BIPSS in the detection and accuracy of lateralization of pituitary adenomas in pediatric patients with Cushing disease (CD) and its possible advantage over other diagnostic methods.
METHODS: This was a multicenter, nationwide, web-based study. The diagnostic value of BIPSS in 16 patients, aged between four and 16.5 years with a confirmed diagnosis of CD, was evaluated retrospectively. The sensitivity and specificity of BIPSS and magnetic resonance imaging (MRI) were calculated, and compared statistically.
RESULTS: Standard tests, except for morning cortisol level, were effective in proving the presence of Cushing syndrome. While MRI findings were consistent with microadenoma in eight cases (50%), CD presence and lateralization was successfully predicted in 14 of 16 patients using BIPSS. BIPSS compared with MRI examination was significantly more accurate, both in pre-stimulation and post-stimulation results (p=0.047 and p=0.041, respectively). BIPSS showed a significantly higher sensitivity (92.8%) than MRI in detecting the pituitary source of adrenocorticotropic hormone secretion.
DISCUSSION AND CONCLUSION: These results suggest that BIPSS is superior to MRI for diagnostic work-up to confirm the diagnosis of CD. Moreover, in line with previous studies, BIPSS was shown to provide better information about adenoma location, which is vital for possible surgical intervention.

Keywords: Cushing’s disease, pituitary adenoma, petrosal sinus sampling, sensitivity, lateralization

Hande Turan, Gönül Çatlı, Aslı Derya Kardelen, Ece Böber, Ayşehan Akıncı, Semra Çetinkaya, Özgecan Demirbaş, Eren Er, Saadet Olcay Evliyaoğlu, Bumin Dündar, Oya Ercan. Diagnostic Value of Bilateral Petrosal Sinus Sampling in Children with Cushing Disease: A Multi-center Study. J Clin Res Pediatr Endocrinol. 2022; 14(1): 29-36

Corresponding Author: Oya Ercan, Türkiye
Manuscript Language: English
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