A framework to objectively identify reference regions for normalizing quantitative imaging

Abstract

The quantitative use of medical images often requires an intensity scaling with respect to the signal from a well-characterized anatomical region of interest. The choice of such a region often varies between studies which can substantially influence the quantification, resulting in study bias hampering objective findings which are detrimental to open science. This study outlines a list of criteria and a statistical ranking approach for identifying normalization region of interest. The proposed criteria include (i) associations between reference region and demographics such as age, (ii) diagnostic group differences in the reference region, (iii) correlation between reference and primary areas..