Repeatability of radiomic features from brain T1-W MRI after image intensity normalization: Implications for longitudinal studies on structural neurodegeneration

Background and Objective: Radiomics extracts quantitative features from magnetic resonance images (MRI)
and is especially useful in the presence of subtle pathological changes within human soft tissues. This scenario,
however, may not cover the effects of intrinsic, e.g., aging-related, (physiological) neurodegeneration of normal
brain tissue. The aim of the work was to study the repeatability of radiomic features extracted from an
apparently normal area in longitudinally acquired T1-weighted MR brain images using three different intensity
normalization approaches typically used in radiomics: Z-score, WhiteStripe and Nyul.
Methods: Fifty-nine images of hearing impaired, yet cognitively intact, patients were repeatedly acquired in
two different time points within six months. Ninety-one radiomic features were obtained from an area within
the pons region, considered to be a healthy brain tissue according to previous analyses and reports. The
Intraclass Correlation Coefficient (ICC) and the Concordance Correlation Coefficient (CCC) in the repeatability
study were used as metrics.
Results: Features extracted from the MRI normalized with Z-score showed results comparable in both ICC
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(0.90 (0.82–0.98)) and CCC (0.82 (0.69–0.95)) distribution values, in terms of median and quartiles, with those
extracted from the images normalized with WhiteStripe (0.89 (0.84–0.92)) and (0.80 (0.73–0.84)), respectively.
Conclusion: Our findings underline the importance of, providing useful guidelines for, the intensity normal-
ization of brain MRI prior to a longitudinal radiomic analysis.