Trying to get the Box Image-As-Content to render the same size as the box

Hi, I am trying to get the image-as-content to take up the same area as the box annotation, but the image doesn't seem to be using the same coordinate system as the box annotation and doesn't scale to fit it as a result:

e.g. with a box annotation rendered at 25,25 -> 75,75 and an image width & height of 50:

Full annotation config: