Role of Indocyanine Green in Predicting Post-Transarterial Chemoembolization Liver Failure in Hepatocellular Carcinoma

Shalimar, ; Jain, Sushil ; Gamanagatti, Shivanand R. ; Kedia, Saurabh ; Thakur, Bhaskar ; Nayak, Baibaswata ; Kaur, Harpreet ; Gunjan, Deepak ; Paul, Shashi B. ; Acharya, Subrat K. (2018) Role of Indocyanine Green in Predicting Post-Transarterial Chemoembolization Liver Failure in Hepatocellular Carcinoma Journal of Clinical and Experimental Hepatology, 8 (1). pp. 28-34. ISSN 09736883

Full text not available from this repository.

Official URL:

Related URL:


Background/aim: Post-Transarterial Chemoembolization (TACE) Liver Failure (LF) is common in patients with Hepatocellular Carcinoma (HCC). No definitive objective parameters predict its occurrence. We assessed the role of Indocyanine Green (ICG) in prediction of post-TACE LF. Methods: Consecutive HCC patients with Child A/B class, categorized as Barcelona Clinic Liver Cancer (BCLC) staging A/B, were included between August 2012 and July 2014. All underwent ICG dynamics: Plasma Disappearance Rate (PDR) was recorded on the day of TACE. Area Under Receiver Operator Characteristic Curve (AUROC) of ICG-PDR was compared with existing prognostic scores: Model for End Stage Liver Disease (MELD), MELD-Na and Child-Turcotte-Pugh (CTP) using Hanley and McNeil method. Results: A total of 43 patients, mean age (±sd) 55.1 ± 12.8 years were included; 35 (81.4%) patients were males. Post-TACE LF developed after 17 (28.8%) of 59 procedures. Patients with post-TACE LF had significantly elevated baseline bilirubin (P = 0.006), alkaline phosphatase (P = 0.040) and prolonged international normalized ratio (P = 0.004). The median prognostic scores were higher in patients with post-TACE LF (CTP 7 vs 6; P < 0.001 and MELD 10.5 vs 6.3; P = 0.005). There was no difference in the MELD-Na score. ICG-PDR values were lower in those patients who developed post-TACE LF (7.4%/min vs 10.6%/min; P = 0.008). AUROC for ICG-PDR was 0.72 and a cut-off value <9.25%/min predicted the development of post-TACE LF with a sensitivity, specificity, positive predictive value and negative predictive value of 64.7%, 61.9%, 40.7% and 81.2%, respectively. There were no differences in the AUROC between ICG-PDR and other prognostic markers (Hanley and McNeil, P: 0.244-0.900). Conclusion: ICG-PDR performs similar to MELD, MELD-Na and CTP score for predicting development of post-TACE LF.

Item Type:Article
Source:Copyright of this article belongs to Elsevier Inc.
Keywords:ACLF; AUROC, Area Under Receiver Operator Characteristic Curve; BCLC, Barcelona Clinic Liver Cancer; HCC, Hepatocellular Carcinoma; ICG, Indocyanine Green; LF, Liver Failure; MELD, model For End Stage Liver Disease; PDR, Plasma Disappearance Rate; TACE, Trans-arterial Chemoembolization; hepatitis B virus; prognosis; treatment
ID Code:128845
Deposited On:22 Nov 2022 09:10
Last Modified:22 Nov 2022 09:12

Repository Staff Only: item control page