Diagnostic value of super-selective bilateral cavernous sinus sampling with hypothalamic stimulating hormone loading in patients with ACTH-producing pituitary adenoma

What Was Tested

This clinical trial paper looks at ACTH (Corticotropin).

Early diagnosis and early treatment by transsphenoidal surgery is desirable for ACTH-producing pituitary microadenoma, but accurate localization of the functional lesion is not always possible before surgery because magnetic resonance (MR) imaging may provide false negative and/or positive findings.

The diagnostic value of super-selective bilateral cavernous sinus sampling with the administration of corticotropin-releasing hormone (CRH) was assessed in patients with functioning ACTH-producing pituitary adenoma.

Who Took Part

The age groups tagged for this paper are adults, middle-aged adults and older adults, both men and women.

Fifteen patients with pituitary adenoma (14 with microadenoma) aged from 23 to 74 years (mean 46.7 years) underwent cavernous sinus sampling with or without the CRH loading test and subsequent transsphenoidal surgery in their institute from October 1997 through to November 2002.

MR imaging including dynamic scan failed to detect the adenomatous lesion in all patients.

How the Study Was Run

To eliminate the bias due to uneven blood flow in the cavernous sinuses and the multi-hormonal response to CRH administration, the ACTH/FSH ratios were evaluated.

The inter-cavernous gradient (ICG) was calculated as the higher/lower ACTH venous blood levels in the right and left cavernous sinuses with or without CRH loading.

The adjusted ICG was calculated using the ACTH/FSH ratios.

The results were compared with the surgical findings.

An ICG of 1.4 or greater was considered to indicate the localization of the responsible lesion.

What Was Measured

The subject headings attached to it are Adenoma, Adrenocorticotropic Hormone, Corticotropin-Releasing Hormone, Diagnosis, Differential, Gadolinium DTPA, Hypophysectomy and Magnetic Resonance Imaging.

What This Means in Plain Language

This is a clinical trial of ACTH (Corticotropin).

Results are reported in around 3 sentences of the abstract; we leave them to the paper itself rather than summarise them.

The publication is from 2005 (Neurological research), a journal based in England.

More context: the ACTH (Corticotropin) compound page, all human trials.