68Ga-pentixafor PET–CT is promising in the differential diagnosis of both ACTH-independent and ACTH-dependent CS. The ACTH-pituitary adenoma detection rate of 68Ga-pentifaxor PET–CT was greater than that of contrast-enhanced MRI of 18F-FDG PET–CT. This evidence concerns the gene POMC and pituitary gland adenoma.