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Bilateral inferior petrosal sinus sampling: Procedural data from a German single-center study.
Anne Marie Augustin1, Mario Detomas2, Viktor Hartung1
1Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Germany.
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Summary
Bilateral inferior petrosal sinus sampling is a safe and effective diagnostic tool for Cushing's syndrome, offering high accuracy. Radiation exposure varies, primarily from fluoroscopy, influenced by patient factors.
Area of Science:
- Endocrinology
- Interventional Radiology
- Diagnostic Imaging
Background:
- Cushing's syndrome diagnosis requires distinguishing pituitary from ectopic sources.
- Bilateral inferior petrosal sinus sampling (BIPSS) is an invasive diagnostic procedure.
Purpose of the Study:
- To evaluate radiation exposure and diagnostic performance of BIPSS.
- To assess BIPSS for differentiating pituitary and ectopic ACTH-dependent Cushing's syndrome.
Main Methods:
- Retrospective analysis of 46 patients undergoing BIPSS.
- Evaluation of procedural data, radiation exposure, and diagnostic accuracy.
- Calculation of sensitivity, specificity, and predictive values.
Main Results:
- High technical success rate (97.8%) and diagnostic performance (sensitivity 97%, specificity 100% post-CRH stimulation).
- Median fluoroscopy time was 7.8 minutes, with radiation dose influenced by patient habitus.
- Low complication rate (2.2%), with vasovagal syncope as the only event.
Conclusions:
- BIPSS is a safe procedure with excellent diagnostic capabilities for Cushing's syndrome.
- Radiation exposure is significant, mainly from fluoroscopy, and patient habitus is a key factor.
- Digital subtraction angiography for catheter placement verification is justified.
