Thursday, August 18, 2011

Selective inferior petrosal sinus sampling without venous outflow diversion in the detection of a pituitary adenoma in Cushing’s syndrome

Lukas Andereggen, Gerhard Schroth, Jan Gralla, Rolf Seiler, Luigi Mariani, Jürgen Beck, Hans-Rudolf Widmer, Robert H. Andres, Emanuel Christ and Christoph Ozdoba

DOI: 10.1007/s00234-011-0915-6



Conventional MRI may still be an inaccurate method for the non-invasive detection of a microadenoma in adrenocorticotropin (ACTH)-dependent Cushing’s syndrome (CS). Bilateral inferior petrosal sinus sampling (BIPSS) with ovine corticotropin-releasing hormone (oCRH) stimulation is an invasive, but accurate, intervention in the diagnostic armamentarium surrounding CS. Until now, there is a continuous controversial debate regarding lateralization data in detecting a microadenoma. Using BIPSS, we evaluated whether a highly selective placement of microcatheters without diversion of venous outflow might improve detection of pituitary microadenoma.


We performed BIPSS in 23 patients that met clinical and biochemical criteria of CS and with equivocal MRI findings. For BIPSS, the femoral veins were catheterized bilaterally with a 6-F catheter and the inferior petrosal sinus bilaterally with a 2.7-F microcatheter. A third catheter was placed in the right femoral vein. Blood samples were collected from each catheter to determine ACTH blood concentration before and after oCRH stimulation.


In 21 patients, a central-to-peripheral ACTH gradient was found and the affected side determined. In 18 of 20 patients where transsphenoidal partial hypophysectomy was performed based on BIPSS findings, microadenoma was histologically confirmed. BIPSS had a sensitivity of 94% and a specificity of 67% after oCRH stimulation in detecting a microadenoma. Correct localization of the adenoma was achieved in all Cushing’s disease patients.


BIPSS remains the gold standard in the detection of a microadenoma in CS. Our findings show that the selective placement of microcatheters without venous outflow diversion might further enhance better recognition to localize the pituitary tumor.

Keywords  Angiography, Digital subtraction – Cushing disease – Petrosal sinus sampling – Pituitary gland – Magnetic resonance imaging

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Tuesday, August 16, 2011

Johns Hopkins Pituitary Patient Day

Join us on September 24, 2011, for the 3rd Annual Patient Education Day at the Johns Hopkins Pituitary Center.

When: Saturday, September 24, 2011
Time: 9:00 a.m.
Johns Hopkins Mt. Washington Conference Center
5801 Smith Avenue,
Baltimore, MD 21209
map and directions

Patient Education Day Agenda:
9:30-10:00 AM Introduction to Sellar Masses Gary Wand, MD
10:00-10:30 AM Neuro-ophthalmological issues in pituitary patients Prem Subramanian, MD
10:30-11:00 AM Medical therapy of pituitary disease Roberto Salvatori, MD
11:00-11:30 AM Surgical Therapy of Pituitary Tumors Alfredo Quinones-Hinojosa, MD
11:30-12:00 PM Approach to Large Invasive Tumors Gary Gallia, MD
12:00-12:30 PM Radiotherapy of pituitary masses Kirsten Redmond, MD
12:30-01:25 PM Lunch
1:30-03:00 PM

Breakout sessions:

  1. Medical therapy (Wand/Salvatori)
  2. Surgical therapy (Gallia/Quinones)
  3. Radiation therapy (Redmond/Lim)
  4. Vision issues (Subramanian)
To RSVP, please contact Colleen Hickson at 410-614-5887 by September 9, 2011.

For more information, contact the Johns Hopkins Pituitary Center at 410-955-GLAN (4526).

Monday, August 15, 2011

Help Cushing's Help at No Cost to You

Help Cushing's Help at no charge to you!


We've just surpassed 21,000 "Likes" on Facebook, so we're celebrating.

We're inviting 21,000 new people to start using iGive by Aug. 31. They'll earn $10 or more free for Cushings Help. Actually, you get to do the inviting, we'll provide the money.

Just send invitees this link or post it on Facebook or other sites (you can even forward this e-mail):

Some Quick Celebration Details:

$5 is donated just for using iGive through 10/31/11. No purchase necessary.
Another $5 (or more) is donated if the new member also makes a purchase by 10/31/11.

Shopping more means helping more. Over 900 great stores participate.
No pop ups, ads, toolbars, special search engine, or unwanted emails.
Our Facebook Page has great testimonials:

New, never before having joined iGive people only qualify for this celebration.
It's a bit of a race so get those invites out soon. Once 21,000 new members are using the iGive Button (for Cushings Help or other causes) or August 31, 2011 happens, the celebration ends.


Robert N. Grosshandler 

Thursday, August 11, 2011

Archived Interviews with MaryO, Cushing's Help Founder

From August 10, 2011

The Coffee Klatch

Listen to internet radio with CushingsHelp on Blog Talk Radio


The Co-Hosts also provided a TweetChat Transcription

#TCK_-_Healthcare_Social_Media_Transcript.pdf Download this file



From January 3, 2008

Interview with Mary O'Connor (MaryO), founder of and 20-year pituitary Cushing's Survivor. Robin (staticnrg) hosts.

Listen to internet radio with CushingsHelp on Blog Talk Radio


These episodes and many more are also available on iTunes podcasts

Read MaryO's bio

Tuesday, August 09, 2011

MaryO will be talking about Cushing's

Tomorrow night at 9:00PM eastern

The Coffee Klatch

Read MaryO's bio