# Indocyanine Green Retention Rate at 15 Minutes as a Key Predictor of Clinically Significant Portal Hypertension in Cirrhosis: Development and Validation of a Superior Non-Invasive Diagnostic Model

## TL;DR

This study shows that a test measuring indocyanine green retention can predict severe liver disease complications in cirrhosis patients.

## Contribution

A novel non-invasive diagnostic model using indocyanine green retention rate to predict portal hypertension in cirrhosis.

## Key findings

- ICG-R15 and liver stiffness strongly correlate with portal hypertension severity.
- A predictive model with ICG-R15 achieved 94.7% accuracy in identifying portal hypertension.
- ICG-R15 is a superior non-invasive marker for clinically significant portal hypertension.

## Abstract

To assess the correlation between indocyanine green retention rate at 15 minutes (ICG-R15), liver stiffness measurement (LSM), and other clinical indicators in cirrhotic patients, using hepatic venous pressure gradient (HVPG) as a reference and to evaluate the predictive capability of ICG-R15 for clinically significant portal hypertension (CSPH).

From February 2023 to September 2024, 80 cirrhotic patients were recruited. Data collected included baseline information, laboratory results, HVPG measurements, and ICG-R15 via the ICG clearance test. Patients were classified into non-CSPH (n = 33) and CSPH (n = 47) groups based on HVPG. Pearson’s correlation analyzed relationships between HVPG, ICG-R15, LSM, and other indicators. Logistic regression was used to identify risk factors for CSPH and develop a predictive model, evaluated by receiver operating characteristic curve.

The CSPH patients showed lower white blood cell count, red blood cell count, hemoglobin, platelet count (PLT), and albumin, with higher total bilirubin (TBil), prothrombin time, LSM, and ICG-R15. Significant correlations were found between HVPG and ICG-R15 (r = 0.662) and LSM (r = 0.633) (both P < .001). The ICG-R15, LSM, PLT, and TBil were independent risk factors for CSPH. The model had an AUC of 0.947, sensitivity of 78.72%, and specificity of 96.97%.

The ICG-R15 is a significant predictor of CSPH, and a model incorporating ICG-R15 can effectively assess disease severity and predict prognosis in cirrhotic patients.