In many application scenarios, the use of Regions of Interest (ROIs) within video sequences is a useful concept. It is shown in this paper how Flexible Macroblock Ordering (FMO), defined in H.264/AVC as an error resilience tool, can be used for the coding arbitrary-shaped ROIs. In order to exploit the coding of ROIs in an H.264/AVC bitstream, a description-driven content adaptation framework is introduced that is able to extract the ROIs of a given bitstream. The results of a series of tests indicate that the ROI extraction process significantly reduces the bit rate of the bitstreams and increases the decoding speed. In case of a fixed camera and a static background, the impact of this reduction on the visual quality of the video sequence is negligible. Regarding the adaptation framework itself, it is shown that in all cases, the framework operates in real time and that it is suited for streaming scenarios by design.