A comparison of bilateral internal jugular vein sampling with bilateral inferior petrosal sinus sampling at Mayo Clinic for the subtype evaluation of corticotropin-dependent cushing syndrome
Authors' conclusion
BIPSS is superior to BIJVS for establishing the source of ACTH hypersecretion in ACTH-dependent Cushing syndrome. BIJVS demonstrates limited diagnostic utility in clinical practice.
Study context
- Population
- Patients with ACTH-dependent Cushing syndrome who underwent simultaneous bilateral inferior petrosal sinus sampling (BIPSS) and bilateral internal jugular vein sampling (BIJVS) at Mayo Clinic (1998–2018); 81 with confirmed diagnoses: 74 Cushing disease (CD), 7 ectopic ACTH-dependent CS81 confirmed diagnoses
- Participants
- 109 patients
- Comparison
- BIJVS vs BIPSS
- Outcome
- Sensitivity and specificity using pre- and post-CRH stimulation criteria
Methodological detailssingle-centre, simultaneous BIPSS and BIJVS, 84 patients proceeded to pituitary surgery based on BIPSS results
- Single-centre
- Simultaneous BIPSS and BIJVS
- 84 patients proceeded to pituitary surgery based on BIPSS results
Performance
As reported in the abstract
Diagnostic performance, combined pre- and post-CRH criteria
| Test or model | Sensitivity | Specificity |
|---|---|---|
| BIJVS | 82% | 86% |
| BIPSS | 100% | 100% |
Sensitivity
BIJVS82%
BIPSS100%
Specificity
BIJVS86%
BIPSS100%
Further findings
| Outcome | BIJVS | BIPSS |
|---|---|---|
| Positive in CD patients at baseline · baseline (pre-CRH) | 35/74 events | 68/74 events |
| Positive in CD patients post-CRH | 59/74 events | 72/74 events |
Original publication
A comparison of bilateral internal jugular vein sampling with bilateral inferior petrosal sinus sampling at Mayo Clinic for the subtype evaluation of corticotropin-dependent cushing syndrome. Pituitary. Published 22 October 2025. doi:10.
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