학술논문
Continuing Challenges in the Definitive Diagnosis of Cushing's Disease: A Structured Review Focusing on Molecular Imaging and a Proposal for Diagnostic Work-Up.
Document Type
Academic Journal
Author
Slagboom TNA; Department of Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.; Pituitary Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands.; Stenvers DJ; Department of Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.; Pituitary Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands.; Department of Endocrinology and Metabolism, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.; van de Giessen E; Pituitary Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Neuroscience, 1105 AZ Amsterdam, The Netherlands.; Roosendaal SD; Pituitary Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.; de Win MML; Pituitary Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Neuroscience, 1105 AZ Amsterdam, The Netherlands.; Bot JCJ; Pituitary Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.; Aronica E; Pituitary Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands.; Department of (Neuro)Pathology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.; Post R; Pituitary Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Neuroscience, 1105 AZ Amsterdam, The Netherlands.; Department of Neurosurgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.; Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands.; Hoogmoed J; Pituitary Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Neuroscience, 1105 AZ Amsterdam, The Netherlands.; Department of Neurosurgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.; Drent ML; Department of Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.; Pituitary Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Neuroscience, 1105 AZ Amsterdam, The Netherlands.; Pereira AM; Department of Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.; Pituitary Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology and Metabolism, 1105 AZ Amsterdam, The Netherlands.; Department of Endocrinology and Metabolism, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Source
Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2077-0383
Abstract
The definitive diagnosis of Cushing's disease (CD) in the presence of pituitary microadenoma remains a continuous challenge. Novel available pituitary imaging techniques are emerging. This study aimed to provide a structured analysis of the diagnostic accuracy as well as the clinical use of molecular imaging in patients with ACTH-dependent Cushing's syndrome (CS). We also discuss the role of multidisciplinary counseling in decision making. Additionally, we propose a complementary diagnostic algorithm for both de novo and recurrent or persistent CD. A structured literature search was conducted and two illustrative CD cases discussed at our Pituitary Center are presented. A total of 14 CD ( n = 201) and 30 ectopic CS ( n = 301) articles were included. MRI was negative or inconclusive in a quarter of CD patients. 11 C-Met showed higher pituitary adenoma detection than 18 F-FDG PET-CT (87% versus 49%). Up to 100% detection rates were found for 18 F-FET, 68 Ga-DOTA-TATE, and 68 Ga-DOTA-CRH, but were based on single studies. The use of molecular imaging modalities in the detection of pituitary microadenoma in ACTH-dependent CS is of added and complementary value, serving as one of the available tools in the diagnostic work-up. In selected CD cases, it seems justified to even refrain from IPSS.