From your link:
Checks if this region has empty space on the specified surface of the drawing.
The operative term in this expression draws a surface . To have a drawing surface, you need a graphics context, and therefore an instance of the Graphics object.
The fact that the documentation mentions the conversion is probably just a little confusing jargon. This is just a fancy way of saying that the return value will be true in the current state of the graph context. If something changes, for example, ScaleTransform or even a vanilla call to DrawLine, then a "transformation" has occurred, and then the result of IsEmpty may be invalid.
Also <I would not be surprised if, in fact, some kind of matrix transformation was applied with the coordinates of the region provided for detecting the "void".
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