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.

BACKGROUND/AIMS: To assess the correlation between indocyanine green retention rate at 15 minutes (ICG-R15), liver stiffness mea surement (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).

MATERIALS AND

METHODS

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.

RESULTS

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%.

CONCLUSION

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.   Cite this article as: Hu H, Lai W, Zhou T, Zhu J, Yan H. 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. Turk J Gastroenterol. 2026;37(2):215-222.