New Imaging Techniques in the Evaluation of Patients With Ectopic Cushing Syndrome
Status:
Completed
Trial end date:
2019-04-26
Target enrollment:
Participant gender:
Summary
Cushing Syndrome is an endocrine disorder causing an over production of the hormone cortisol.
Cortisol is produced in the adrenal gland as a response to the production of corticotropin
(ACTH) in the pituitary gland.
Between 10% and 20% of patients with hypercortisolism (Cushing Syndrome) have ectopic
production of the hormone ACTH. Meaning, the hormone is not being released from the normal
site, the pituitary gland. In many cases the ectopic ACTH is being produced by a tumor of the
lung, thymus, or pancreas. However, in approximately 50% of these patients the source of the
ACTH cannot be found even with the use of extensive imaging studies such as computed
tomography (CT) scans, magnetic resonance imaging (MRI), and nuclear scans (111-indium
pentetreotide). The ability of these tests to locate the source of the hormone production is
dependent on the changes of anatomy and / or the dose and adequate uptake of the radioactive
agent. The inability to detect the source of ectopic ACTH production often results in
unnecessary pituitary surgery or irradiation.
Unlike the previously described tests, positron emission tomography (PET scan) has the
ability to detect pathologic tissue based on physiologic and biochemical processes within the
abnormal tissue.
This study will test whether fluorine-18-fluorodeoxyglucose (FDG),
fluorine-18-dihydroxyphenylalanine (F-DOPA) or use of a higher dose of 111-indium
pentetreotide can be used to successfully localize the source of ectopic ACTH production.
Phase:
Phase 2
Details
Lead Sponsor:
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)