Frete C, Corcuff JB, Kuhn E, et al. - In this retrospective study, researchers tested a noninvasive diagnostic strategy correlated with 100% positive predictive value (PPV) for Cushing disease (CD). In total, 167 patients with CD and 27 patients with ectopic ACTH-syndrome examined between 2001 and 2016. Data reported that the sensitivity and PPV for pituitary MRI, respectively, were 71% and 99%. At presentation, CT scan identified 67% EAS with no false-positives. In patients with positive responses to both tests, the PPV for CD was 100% with negative pituitary MRI and CT scans. In patients with negative responses to both tests, the Negative Predictive Value was 100% with negative pituitary MRI and positive CT scan. IPPS could have been avoided using this strategy in 47% of patients in whom it is currently recommended. The non-invasive algorithm studied, in conjunction with expert radiologic interpretation, significantly reduces the need for IPSS in investigating ACTH-dependent Cushing’s syndrome.