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Widely Used Calculations of Intracranial Volume Provide Inaccurate Estimates in Developmental Cohorts: Evidence and Solutions for the Neuroimaging Community

Skyberg, A. M.; Reck, A. J.; Smith, J.; Newman, B. T.; Goldberg, M. N.; Druzgal, T. J.; Van Horn, J. D.; Pfeifer, J. H.

2026-10-08 neuroscience
10.64898/2026.10.03.751882 bioRxiv
Show abstract

Intracranial volume (ICV) is often estimated as part of automated neuroimaging processing pipelines and commonly used to account for and characterize cranial size. FreeSurfer's estimated intracranial volume (eTIV) produces implausible longitudinal estimates in developmental samples when using versions prior to FreeSurfer 8. Across two different adolescent datasets, we document eTIV changes of up to 39% between 1.5 - 2 year sessions for FreeSurfer 7, with errors more pronounced on Siemens scanners and in female participants. These errors are markedly reduced in FreeSurfer 8 and AssemblyNet. However, the widespread use of FreeSurfer 7 raises concern about developmental neuroimaging studies that utilize eTIV without quality control.

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