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Although alcohol is metabolized in the liver, the effects of PAE on the fetal liver are unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      For this study,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921 prenatal MRIs of fetuses with PAE and\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200945 MRIs of fetuses without PAE were included. To assess macroscopic organ development, liver volumetry was conducted and compared to an established prenatal estimation formula. A texture-based radiomics analysis based on ensemble (random forest) and linear (L2-penalized logistic regression) models was conducted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PAE and non-PAE fetuses were age-matched (gestational age 27.4 [IQR 25.1\u201330.0] vs. 26.7 [25.4\u201329.3] weeks,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.650). PAE had no effect on liver volume (normalized per gestational week,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.971) or signal intensity (SI) in T1 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.574) and T2 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.104). MRI-derived liver volumetry correlated strongly with a gestational age-based volume estimation regardless of PAE (both r\u2009&gt;\u20090.75,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A texture-based radiomics analysis was unable to discern between PAE and no-PAE fetuses (ROC-AUC\u2009=\u20090.43, 95% CI 0.29\u20130.57 for random forest, ROC-AUC\u2009=\u20090.40, 95% CI 0.31\u20130.60 for L2-penalized logistic regression).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PAE had no significant effect on signal intensity of the fetal liver, and gestational-age-adjusted liver volumes did not differ between fetuses with and without PAE, suggesting no relevant effect on organ development. Texture-based radiomics were unable to identify PAE. Hence, alterations of the liver in fetal MRI with known PAE warrant investigations for causes other than alcohol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Prenatal alcohol exposure can lead to morphological and neurocognitive changes in the fetus. The effect on the fetal liver is unknown<\/jats:italic>\n                      <jats:italic>.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>No differences in fetal liver volume or signal intensity were found regarding alcohol exposure. Texture-based radiomics analysis was unable to discern between the two groups<\/jats:italic>\n                      <jats:italic>.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Fetal MRI and radiomics analysis were unable to detect effects of alcohol exposure on the fetal liver. Aberrations of the fetal liver on MRI in patients with a history of prenatal alcohol exposure warrant investigation for other causes<\/jats:italic>\n                      <jats:italic>.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-026-12461-3","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T14:12:05Z","timestamp":1773670325000},"page":"6410-6418","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of fetal MRI data reveals no effect on liver maturation following prenatal alcohol exposure"],"prefix":"10.1007","volume":"36","author":[{"given":"Michael","family":"Schwarz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Watzenboeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Stuempflen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Tontsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patric","family":"Kienast","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Binder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Dorittke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Sokol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix Ragnar Merlin","family":"Koenig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Schwarz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Prayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Kasprian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3599-1436","authenticated-orcid":false,"given":"Victor Ulrich","family":"Schmidbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"12461_CR1","first-page":"477","volume":"25","author":"D Lemoine","year":"1968","unstructured":"Lemoine D (1968) Les enfants de parents alcoholiques anomalies, observees de 127 cas. 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Martin Watzenb\u00f6ck: Nothing to disclose. Marlene Stuempflen: Nothing to disclose. Katharina Tontsch: Nothing to disclose. Patric Kienast: Nothing to disclose. Julia Binder: Received speaking honoraria from Roche Diagnostics and honoraria from Biomarin (advisory board for Achondroplasia). Tim Dorittke: Nothing to disclose. Rebecca Sokol: Nothing to disclose. Felix Ragnar Merlin K\u00f6nig: Nothing to disclose. Caroline Schwarz: received travel support from Gilead, AbbVie, and Gebro; speaking honoraria from AbbVie and Gilead; and payments for consulting from Gilead. Thomas Reiberger: received grant support from Abbvie, Boehringer Ingelheim, Gilead, Intercept\/Advanz Pharma, Philips Healthcare, Pliant, Siemens and W. L. Gore & Associates; speaking honoraria from Abbvie, Gilead, Intercept\/Advanz Pharma, Roche, MSD, W. L. Gore & Associates; consulting\/advisory board fee from Abbvie, AstraZeneca, Bayer, Boehringer Ingelheim, Gilead, Resolution Therapeutics, Siemens; and travel support from Dr. Falk Pharma. Daniela Prayer: Nothing to disclose. Gregor Kasprian: Nothing to disclose. Victor Ulrich Schmidbauer: Nothing to disclose.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Informed consent for the scientific use of the acquired data was obtained prior to MRI.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"This study was conducted in concordance with the principles of the Declaration of Helsinki, as approved by the local ethics committee.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This study cohort overlaps with patients analyzed in Stuempflen et al [\n                      \n                      ]. Out of 500 pregnant women undergoing prenatal MRI, this manuscript analyzed 24 fetuses (26 observations) with prenatal alcohol exposure and 52 age-matched controls without alcohol exposure. The focus of this study was alterations of the fetal brain after prenatal alcohol exposure.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}