We describe IBEX, an open-source tool designed for medical imaging radiomics studies, and how to use this tool. In addition, some published works that have used IBEX for uncertainty analysis and model building are showcased.
Imaging Biomarker Explorer (IBEX) is an open-source tool for medical imaging radiomics work. The purpose of this paper is to describe how to use IBEX’s graphical user interface (GUI) and to demonstrate how IBEX calculated features have been used in clinical studies. IBEX allows for the import of DICOM images with DICOM radiation therapy structure files or Pinnacle files. Once the images are imported, IBEX has tools within the Data Selection GUI to manipulate the viewing of the images, measure voxel values and distances, and create and edit contours. IBEX comes with 27 preprocessing and 132 feature choices to design feature sets. Each preprocessing and feature category has parameters that can be altered. The output from IBEX is a spreadsheet that contains: 1) each feature from the feature set calculated for each contour in a data set, 2) image information about each contour in a data set, and 3) a summary of the preprocessing and features used with their selected parameters. Features calculated from IBEX have been used in studies to test the variability of features under different imaging conditions and in survival models to improve current clinical models.
In medicine, patient disease diagnosis typically incorporates a large number of diagnostic exams such as x-rays, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans to assist in determining the course of patient care. While physicians use these images to qualitatively assess patient's diagnosis, there may be additional quantitative features that can be extracted to guide patient care. The rationale is that these features may represent proteomic and genomic patterns expressed on the macroscopic scale1. Combining this quantitative information with the current clinical information, e.g., patient demographics, may allow more individualized patient care. This is the theory behind radiomics: feature analysis of images on a voxel level. The features typically fall into 5 main categories: gray level co-occurrence matrix, gray level run length matrix, neighborhood intensity difference matrix, histogram, and shape.
Imaging Biomarker Explorer (IBEX) is an open-source tool for radiomics work2. The graphical user interface (GUI) was developed at MD Anderson Cancer Center with the goal of facilitating the extraction and calculation of quantitative features to assist in decision making in cancer care. A source code3 and a stand-alone4 version are available online. IBEX calculates the 5 most common categories of features used in medical radiomics with parameters that can be set for each feature category. The categories are: gray level co-occurrence matrix5, gray level run length matrix6,7, intensity, neighborhood intensity difference matrix8, and shape. Since IBEX is open source, it allows for harmonized feature extraction results across institutions to easily compare different radiomics studies. All features within IBEX are described in the initial paper by Zhang et al.2
The purpose of this manuscript is to provide guidance on how to use IBEX and to demonstrate its applications through peer-reviewed published studies from the MD Anderson radiomics group. Since its release to the public in 2015, IBEX has been used to calculate features from CT, PET, and MRI scan images by the MD Anderson radiomics group, typically investigating features to improve clinical survival models9,10,11,12,13,14,15,16,17,18,19,20 and by outside institutions21,22,23,24. Additional guidance on software tools that can be used for the steps in radiomics research that are not included in IBEX can be found in Court et al.25
A general introduction to the workflow of IBEX will help to organize data properly before starting radiomics projects utilizing IBEX. If importing DICOM images, IBEX requires that each patient have their own folder with their DICOM images. DICOM radiation structure set is optional to include in the patient folder, but is recommended instead of using the contouring platform in IBEX. To assist with importing all patients for a specific study, all patient folders can be placed into one folder together so that all data may be imported into IBEX using only one step. If importing patients from Pinnacle, it is best to have the structure set with the patient plan. As patients may have multiple image sets and plans within Pinnacle, it is best to know which image set and plan are correct before importing. If computation time is a concern, reducing the number of image slices for a patient can drastically reduce time. For example, if only the liver is of interest in a study but the patients have full body CT scans, reducing the DICOM slices to only the extent of the area of interest can shorten computation time (e.g., reducing the DICOM from 300 slices to 50 slices can take 1/6th the time). There are different tools available to perform this slice reduction, from manual to semi-automatic.
IBEX is a powerful tool for medical imaging radiomics research. It has thus far mostly been used for radiation oncology purposes in studies conducted by the MD Anderson radiomics group. IBEX allows for manipulation of ROIs and calculation of features within 5 main feature categories. The source code version of IBEX allows the user to design applications that are not already part of IBEX, such as gray level zone matrix features.
The main steps involved in IBEX are the import of images, contouri…
The authors have nothing to disclose.
Rachel Ger is funded by the Rosalie B. Hite Graduate Fellowship and American Legion Auxiliary Fellowship. Carlos Cardenas has been funded by the George M. Stancel PhD Fellowship in the Biomedical Sciences. The development of IBEX was funded by the NCI (R03 CA178495).
Excel | Microsoft Office | Any version of excel should work. | |
Matlab | MathWorks | Only use IBEX on 32 bit Matlab 2011a or 64 bit Matlab 2014b. |