BIOMAT Database Logo BIOMAT Database Logo

High-dose dexamethasone suppression test is inferior to pituitary dynamic enhanced MRI in the differential diagnosis of ACTH-dependent Cushing's syndrome. 2022

Xiaoli Shi, and Tingting Du, and Dan Zhu, and Delin Ma, and Kun Dong, and Xuemin Peng, and Jiaojiao Huang, and Ting Lei, and Xuefeng Yu, and Juan Chen, and Yan Yang
Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, P.R. China.

OBJECTIVE The differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome remains a challenge in clinical practice. The present study was aimed at assessing the diagnostic performance of pituitary dynamic contrast-enhanced magnetic resonance imaging (dMRI), high-dose dexamethasone suppression test (HDDST), and a combination of both tests for patients with ACTH-dependent Cushing's syndrome. METHODS A total of 119 consecutive patients with ACTH-dependent Cushing's syndrome confirmed surgically were enrolled: 101 with proven Cushing's disease and 18 with proven ectopic ACTH syndrome. All patients underwent pituitary dMRI and HDDST. The sensitivity and specificity of pituitary dMRI, HDDST, and a combination of both tests were determined. RESULTS The sensitivity and specificity of pituitary dMRI for diagnosing Cushing's disease were 80.2 and 83.3%, respectively, with a positive predictive value of 96.4%. The sensitivity and specificity of HDDST were 70.3 and 77.8%, respectively, with positive predictive value of 94.7%. A combination of both tests showed that the combined criteria of more than 50% suppression of serum cortisol on HDDST and a positive pituitary dMRI finding yielded a high specificity of 94.4 and sensitivity of 59.4%. The combined criteria of more than 68% suppression on HDDST and/or a positive pituitary dMRI finding yielded a sensitivity of 86.1% and specificity of 83.3%. CONCLUSIONS Pituitary dMRI was superior to HDDST in the differential diagnosis of ACTH-dependent Cushing's syndrome. HDDST is recommended in combination with pituitary dMRI to establish a diagnosis process because of the significantly increased specificity with the combination.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D003480 Cushing Syndrome A condition caused by prolonged exposure to excess levels of cortisol (HYDROCORTISONE) or other GLUCOCORTICOIDS from endogenous or exogenous sources. It is characterized by upper body OBESITY; OSTEOPOROSIS; HYPERTENSION; DIABETES MELLITUS; HIRSUTISM; AMENORRHEA; and excess body fluid. Endogenous Cushing syndrome or spontaneous hypercortisolism is divided into two groups, those due to an excess of ADRENOCORTICOTROPIN and those that are ACTH-independent. Cushing's Syndrome,Hypercortisolism,Syndrome, Cushing,Syndrome, Cushing's
D003907 Dexamethasone An anti-inflammatory 9-fluoro-glucocorticoid. Hexadecadrol,Decaject,Decaject-L.A.,Decameth,Decaspray,Dexasone,Dexpak,Hexadrol,Maxidex,Methylfluorprednisolone,Millicorten,Oradexon,Decaject L.A.
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006854 Hydrocortisone The main glucocorticoid secreted by the ADRENAL CORTEX. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. Cortef,Cortisol,Pregn-4-ene-3,20-dione, 11,17,21-trihydroxy-, (11beta)-,11-Epicortisol,Cortifair,Cortril,Epicortisol,Hydrocortisone, (11 alpha)-Isomer,Hydrocortisone, (9 beta,10 alpha,11 alpha)-Isomer,11 Epicortisol
D000182 ACTH Syndrome, Ectopic Symptom complex due to ACTH production by non-pituitary neoplasms. Ectopic ACTH Syndrome,ACTH Syndromes, Ectopic,Ectopic ACTH Syndromes,Syndrome, Ectopic ACTH,Syndromes, Ectopic ACTH
D000324 Adrenocorticotropic Hormone An anterior pituitary hormone that stimulates the ADRENAL CORTEX and its production of CORTICOSTEROIDS. ACTH is a 39-amino acid polypeptide of which the N-terminal 24-amino acid segment is identical in all species and contains the adrenocorticotrophic activity. Upon further tissue-specific processing, ACTH can yield ALPHA-MSH and corticotrophin-like intermediate lobe peptide (CLIP). ACTH,Adrenocorticotropin,Corticotropin,1-39 ACTH,ACTH (1-39),Adrenocorticotrophic Hormone,Corticotrophin,Corticotrophin (1-39),Corticotropin (1-39),Hormone, Adrenocorticotrophic,Hormone, Adrenocorticotropic

Related Publications

Xiaoli Shi, and Tingting Du, and Dan Zhu, and Delin Ma, and Kun Dong, and Xuemin Peng, and Jiaojiao Huang, and Ting Lei, and Xuefeng Yu, and Juan Chen, and Yan Yang
Low Diagnostic Utility of Overnight High-Dose Dexamethasone Suppression Test in ACTH-Dependent Cushing's Syndrome.
July 2021, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists,
Xiaoli Shi, and Tingting Du, and Dan Zhu, and Delin Ma, and Kun Dong, and Xuemin Peng, and Jiaojiao Huang, and Ting Lei, and Xuefeng Yu, and Juan Chen, and Yan Yang
A very high dose dexamethasone suppression test for differential diagnosis of Cushing's syndrome.
January 1998, Clinical endocrinology,
Xiaoli Shi, and Tingting Du, and Dan Zhu, and Delin Ma, and Kun Dong, and Xuemin Peng, and Jiaojiao Huang, and Ting Lei, and Xuefeng Yu, and Juan Chen, and Yan Yang
An Optimized Pathway for the Differential Diagnosis of ACTH-Dependent Cushing's Syndrome Based on Low-Dose Dexamethasone Suppression Test.
January 2021, Frontiers in endocrinology,
Xiaoli Shi, and Tingting Du, and Dan Zhu, and Delin Ma, and Kun Dong, and Xuemin Peng, and Jiaojiao Huang, and Ting Lei, and Xuefeng Yu, and Juan Chen, and Yan Yang
The continuous 7-hour intravenous dexamethasone suppression test in the differential diagnosis of ACTH-dependent Cushing's syndrome.
August 1999, Clinical endocrinology,
Xiaoli Shi, and Tingting Du, and Dan Zhu, and Delin Ma, and Kun Dong, and Xuemin Peng, and Jiaojiao Huang, and Ting Lei, and Xuefeng Yu, and Juan Chen, and Yan Yang
[Value of desmopressin stimulation test and high dose dexamethasone suppression testin the etiologic diagnosis of ACTH dependent Cushing's syndrome].
March 2016, Zhonghua yi xue za zhi,
Xiaoli Shi, and Tingting Du, and Dan Zhu, and Delin Ma, and Kun Dong, and Xuemin Peng, and Jiaojiao Huang, and Ting Lei, and Xuefeng Yu, and Juan Chen, and Yan Yang
An overnight high-dose dexamethasone suppression test for rapid differential diagnosis of Cushing's syndrome.
February 1986, Annals of internal medicine,
Xiaoli Shi, and Tingting Du, and Dan Zhu, and Delin Ma, and Kun Dong, and Xuemin Peng, and Jiaojiao Huang, and Ting Lei, and Xuefeng Yu, and Juan Chen, and Yan Yang
High positive predictive value of the combined pituitary dynamic enhanced MRI and high-dose dexamethasone suppression tests in the diagnosis of Cushing's disease bypassing bilateral inferior petrosal sinus sampling.
September 2020, Scientific reports,
Xiaoli Shi, and Tingting Du, and Dan Zhu, and Delin Ma, and Kun Dong, and Xuemin Peng, and Jiaojiao Huang, and Ting Lei, and Xuefeng Yu, and Juan Chen, and Yan Yang
DIAGNOSIS OF CUSHING'S SYNDROME; SINGLE DOSE DEXAMETHASONE SUPPRESSION TEST.
August 1965, Archives of internal medicine,
Xiaoli Shi, and Tingting Du, and Dan Zhu, and Delin Ma, and Kun Dong, and Xuemin Peng, and Jiaojiao Huang, and Ting Lei, and Xuefeng Yu, and Juan Chen, and Yan Yang
Nocturnal high-dose dexamethasone suppression test in the aetiological diagnosis of Cushing's syndrome.
June 1985, Acta endocrinologica,
Xiaoli Shi, and Tingting Du, and Dan Zhu, and Delin Ma, and Kun Dong, and Xuemin Peng, and Jiaojiao Huang, and Ting Lei, and Xuefeng Yu, and Juan Chen, and Yan Yang
A comparison of the standard high dose dexamethasone suppression test and the overnight 8-mg dexamethasone suppression test for the differential diagnosis of adrenocorticotropin-dependent Cushing's syndrome.
February 1994, The Journal of clinical endocrinology and metabolism,
Copied contents to your clipboard!