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Current methods are often costly, invasive, or lack sensitivity in early stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the feasibility and accuracy of microwave\u2010induced thermoacoustic\/ultrasound (TAI\/US) dual\u2010modality imaging for the assessment of hepatic steatosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A microwave\u2010induced TAI\/US dual\u2010modality imaging system with a microwave source at a center frequency of 3\u00a0GHz as an excitation source was applied to image rabbit NAFLD models, and the spleen\u2010to\u2010liver thermoacoustic amplitude ratio (TAR\n                      <jats:sub>S\u2010L<\/jats:sub>\n                      ) parameter was introduced to assess hepatic steatosis. Pathology was used as the gold standard, and Oil Red O staining fat fraction (ORO\u2010FF) was calculated by a semi\u2010quantitative software. Group differences in TAR\n                      <jats:sub>S\u2010L<\/jats:sub>\n                      across hepatic steatosis grades were assessed using the Kruskal\u2013Wallis test with Dunn\u2010Bonferroni post hoc comparisons. The Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test and Cliff's Delta (\u03b4) were applied to compare dichotomized steatosis subgroups. Spearman's rank correlation coefficient was used to evaluate the association between TAR\n                      <jats:sub>S\u2010L<\/jats:sub>\n                      and ORO\u2010FF. Receiver Operating Characteristic (ROC) curve was performed to assess the diagnostic performance of TAR\n                      <jats:sub>S\u2010L<\/jats:sub>\n                      , and the results were quantified by the Area Under the Curve (AUC). A\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.05 was considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results demonstrated that the thermoacoustic and ultrasound images from the microwave\u2010induced TAI\/US dual\u2010modality imaging system could be well\u2010fused. The median TAR\n                      <jats:sub>S\u2010L<\/jats:sub>\n                      values for normal (S0), mild (S1), moderate (S2), and severe (S3) steatosis were 1.110 (0.953\u20131.283), 1.260 (1.073\u20131.430), 1.740 (1.625\u20131.870), and 2.195 (1.833\u20132.580). TAR\n                      <jats:sub>S\u2010L<\/jats:sub>\n                      values increased with steatosis severity, showing a strong positive correlation with ORO\u2010FF (\n                      <jats:italic>r\u00a0<\/jats:italic>\n                      =\u00a00.908,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.001). Statistically significant differences with large effect sizes were observed in TAR\n                      <jats:sub>S\u2010L<\/jats:sub>\n                      between S0 vs. S3 and S1 vs. S3 (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.05, |Cliff's\n                      <jats:italic>\u03b4<\/jats:italic>\n                      |\u00a0&gt;\u00a00.474), indicating marked group differences. While comparisons such as S0 vs. S2 and S1 vs. S2 lacked statistical significance (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &gt;\u00a00.05), large effect sizes (|Cliff's\n                      <jats:italic>\u03b4<\/jats:italic>\n                      |\u00a0&gt;\u00a00.474) suggest potential true differences limited by sample size. ROC analysis confirmed diagnostic performance, with AUC of 0.894 (0.764\u20131.000), 0.979 (0.931\u20131.000), and 0.953 (0.874\u20131.000) for distinguishing S0 vs. \u2265S1, \u2264S1 vs. \u2265S2, and \u2264S2 vs. S3, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      At present, the diagnosis of NAFLD based on TAI still belongs to the research gap. Our study initially verified the potential of microwave\u2010induced TAI\/US dual\u2010modality imaging combined with the thermoacoustic parameter TAR\n                      <jats:sub>S\u2010L<\/jats:sub>\n                      for the diagnosis of NAFLD. These findings establish a crucial methodological foundation for subsequent in\u2010depth investigations into the application of microwave\u2010induced TAI\/US dual\u2010modality imaging in the quantitative diagnosis of hepatic steatosis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.70075","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T06:00:39Z","timestamp":1762236039000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Feasibility study of microwave\u2010induced thermoacoustic\/ultrasound dual\u2010modality imaging for the assessment of nonalcoholic fatty liver disease"],"prefix":"10.1002","volume":"52","author":[{"given":"Jieni","family":"Song","sequence":"first","affiliation":[{"name":"Department of Ultrasound, West China Hospital Sichuan University Chengdu 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