Objective: To develop an automatic image normalization algorithm for intensity correction of images from breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) acquired by different MRI scanners with various imaging parameters, using only image information. Methods: DCE-MR images of 460 subjects with breast cancer acquired by different scanners were used in this study. Each subject had one T1-weighted pre-contrast image and three T1-weighted post-contrast images available. Our normalization algorithm operated under the assumption that the same type of tissue in different patients should be represented by the same voxel value. We used four tissue/material types as the anchors for the normalization: 1) air, 2) fat tissue, 3) dense tissue, and 4) heart. The algorithm proceeded in the following two steps: First, a state-of-the-art deep learning-based algorithm was applied to perform tissue segmentation accurately and efficiently. Then, based on the segmentation results, a subject-specific piecewise linear mapping function was applied between the anchor points to normalize the same type of tissue in different patients into the same intensity ranges. We evaluated the algorithm with 300 subjects used for training and the rest used for testing. Results: The application of our algorithm to images with different scanning parameters resulted in highly improved consistency in pixel values and extracted radiomics features. Conclusion: The proposed image normalization strategy based on tissue segmentation can perform intensity correction fully automatically, without the knowledge of the scanner parameters. Significance: We have thoroughly tested our algorithm and showed that it successfully normalizes the intensity of DCE-MR images. We made our software publicly available for others to apply in their analyses.
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