title: Indocyanine green clearance test (using spectrophotometry) and its correlation with model for end stage liver disease (MELD) score in Indian patients with cirrhosis of liver.
abstract: BACKGROUND
  Child Turcotte Pugh (CTP) score and Model for End Stage Liver Disease (MELD) are used commonly to assess the prognosis of liver disease but the disadvantage of these static tests is their inability to identify the functional reserve of the liver. Among all quantitative liver function tests indocyanine green (ICG) clearance test is most widely used and has been used to determine operative risk before hepatectomy and to assess prognosis of patients with cirrhosis.
  
  
  OBJECTIVE
  To correlate indocyanine green (ICG) clearance test with MELD score in patients with cirrhosis of liver.
  
  
  METHODS
  Forty patients with cirrhosis of liver were included and divided into two groups according to their CTP scores. Group A had 20 patients with CTP class A and group B had 20 patients with CTP class B. After ICG injection, ICG retention at 15 minutes (ICGR 15) and ICG clearance rate were calculated.
  
  
  RESULTS
  In group A, the mean ICGR15 was 32.86% +/- 6.4% while in group B it was 51.08% +/-12.8% (p <0.001). ICG clearance rates were 4.3% +/- 2.8% and 3.5% +/- 3.8% per minute in group A and B respectively. MELD score had a strong positive correlation with ICGR15 but a negative correlation with ICG clearance rate. On ROC curve analysis, AUC for MELD was 0.805 vs. 0.88 for ICGR15 in assessing prognosis of patients with cirrhosis. The sensitivity and specificity of MELD score was 60% and 80% respectively while that of ICGR15 was 85% and 90% respectively.
  
  
  CONCLUSIONS
  ICGR15 has a higher sensitivity and specificity than MELD score in assessing the prognosis of patients with cirrhosis of liver.
authors.affiliation: Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sachin
authors.initials: S
authors.lastname: Gupta
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Chawla
authors.forename: Jyotdeep
authors.initials: J
authors.lastname: Kaur
authors.forename: Roli
authors.initials: R
authors.lastname: Saxena
authors.forename: Ajay
authors.initials: A
authors.lastname: Duseja
authors.forename: R K
authors.initials: RK
authors.lastname: Dhiman
authors.forename: Narendra S
authors.initials: NS
authors.lastname: Choudhary
mesh_terms: D058625:End Stage Liver Disease / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007194:India; D007208:Indocyanine Green / Q000493:pharmacokinetics*; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012720:Severity of Illness Index; D013053:Spectrophotometry
chemical_list: D007208:Indocyanine Green