Session: MON 88-111-Cushing's Disease & Non-Functioning Hypothalamus-Pituitary Tumors
Poster Board MON-92
Methods: Five patients with CD, (4 F, mean age 26.4 ± 16.7y) were studied. Four of the 5 patients were surgically cured of disease with post-operative measurements of plasma cortisol < 2 μg/dl as previously described (1). MSI was performed on the right cheek of the patient prior to TSS and a mean of 7 ± 3 days after surgery using 4 wavelengths (700,750, 800 and 850nm) with a Near Infrared CCD based system. Spectral analysis using the two layers skin model along with a curvature correction algorithm are used to quantify the fraction of blood volume as well as the oxygenation of the tissue (2). Data are presented as mean ± SD.
Results: The mean value of total blood fraction per unit volume (2mm3) captured from the right cheek of patients significantly decreased when measured before and after TSS in the 4 patients who entered remission for their CD (0.16. ± 0.02 to 0.12 ± 0.01, p = 0.012). In contrast, in the one patient who was not surgically cured, the fraction of blood volume increased from pre to post operative measurements (0.13 to 0.18). Pre-op UFC and AM cortisol values were elevated at 125.8 ± 56.6 μg/dL /24hr/m2 and 19.1± 5.4 μg/dL, respectively. In the 5 patients tested, there was not a significant correlation between pre-surgical UFC or serum cortisol and degree of facial plethora as measured by MSI. Post-op AM cortisol in the 4 cured patients was 1.2 ± 0.2 μg/dL, whereas the AM cortisol in the patient with persistent disease was 12.5 μg/dL.
Conclusions: In this pilot study, preliminary data indicate that a decrease in facial plethora after TSS correlates with cure of CD. This novel technology is very promising as a marker of early cure of Cushing disease after TSS, along with biochemical data.
Nothing to Disclose: MBL, YA, EG, MK, AA, EB, CL, VC, AG, CAS
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