{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T09:02:08Z","timestamp":1785315728577,"version":"3.55.0"},"reference-count":39,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Automated brain volumetry is increasingly integrated into the work-up of several neurological disorders, yet between-software variability may limit the interchangeability of absolute measures. This study aimed to assess inter-software variability, agreement, and interchangeability among four clinically available AI-based brain volumetry tools. Methods: We conducted a single-center, retrospective comparison of four clinically available tools (Neurophet AQUA\u00ae, icobrain dm\u00ae, mdbrain\u00ae, Pixyl\u00ae) applied to identical 3D T1-weighted MRI examinations (IR-FSPGR, 1 mm isotropic) acquired at 3 T in 47 adults referred for tremor evaluation. Absolute volumes (mL) were extracted for hippocampus, temporal, parietal, and frontal lobes, lateral ventricles, and total brain volume; the occipital lobe was analyzed where reported (three tools). Region-wise complete-case analyses were performed. Repeated-measures ANOVA with Bonferroni post hoc tests assessed systematic differences, and intraclass correlation coefficients (two-way mixed, consistency) were reported as single- and average-measure with 95% CIs to quantify agreement. Results: Across regions, all tests were significant (p &lt; 0.001), indicating method-dependent scale offsets typically on the order of ~20\u201340%. A consistent pattern emerged: icobrain dm\u00ae yielded the largest absolute volumes, Neurophet AQUA\u00ae the lowest, mdbrain\u00ae tended to be lower for parietal measurements, and Pixyl\u00ae was generally intermediate. Agreement was structure-dependent: excellent for lateral ventricles (single-measure ICC \u2248 0.92 [0.85\u20130.96]; average-measure ICC \u2248 0.98 [0.96\u20130.99]); good-to-excellent for temporal and parietal lobes (average-measure ICC \u2248 0.83\u20130.84); moderate-to-good for hippocampus and total brain volume (TBV) (average-measure ICC \u2248 0.79\u20130.81), with only moderate single-measure agreement for TBV (ICC \u2248 0.51); and lowest for the frontal lobe (single-measure ICC \u2248 0.43 [0.23\u20130.65]; average-measure ICC \u2248 0.75 [0.54\u20130.88]). In the occipital lobe (three tools), Neurophet AQUA\u00ae yielded substantially smaller values than icobrain dm\u00ae and mdbrain\u00ae (p &lt; 0.0001). Conclusions: Overall, absolute volumetric outputs are not directly interchangeable across platforms, but relative subject ranking is largely preserved; platform-consistent analysis is advisable for longitudinal monitoring, and cross-site studies should implement calibration\/harmonization before pooling data.<\/jats:p>","DOI":"10.3390\/diagnostics16152383","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T08:16:52Z","timestamp":1785313012000},"page":"2383","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Analysis of Four Commercially Available Artificial Intelligence Software for Brain Volumetry"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4834-4219","authenticated-orcid":false,"given":"Gaspare","family":"Saltarelli","sequence":"first","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Di Cerbo","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Innocenzi","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"De Chellis","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1444-2585","authenticated-orcid":false,"given":"Federico","family":"Bruno","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2188-3506","authenticated-orcid":false,"given":"Alessandra","family":"Splendiani","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0995-3081","authenticated-orcid":false,"given":"Ernesto","family":"Di Cesare","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1038\/s41572-021-00314-w","article-title":"Essential tremor","volume":"7","author":"Welton","year":"2021","journal-title":"Nat. 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