Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Sto. Tomas Branch
Organization of Electronics and Communications
Engineering Students

CHAPTER 1

INTRODUCTION

Human brain is the most intricate organ in the human body.

Despite of the unceasing encroachment in medical science, the entire
functionality of the brain is still enigmatic for medical connoisseurs as
new types of neurons and functions are learned every now and then.
Developments in medicine are meant to cure diseases. As the human
brain is a delicate body organ, convoluted diseases cannot be eluded.
One of the known brain diseases nowadays is the Multiple Sclerosis.

Multiple sclerosis (MS) is one of the most common diseases of

the central nervous systemincluding the brain, spinal cord, and optic
nerveswhich affects more than 2.3 million people worldwide. MS is an
inflammatory demyelinating condition where an abnormal response by
the immune system damages myelin, the fatty protein that insulates
and protects nerve cells called axons. When myelin or axons are
damaged, electrical nerve impulses transmitted to and from the brain
and spinal cord are distorted or interrupted which may result in a
variety of symptoms (Emrich, 2009). According to the article by Lisa
Emrich, entitled Beginner's Guide to MS: What is Multiple Sclerosis?,
most people are diagnosed with MS between the ages of 20 and 50,
but MS can appear in young children and teens as well as much older
adults and is significantly more conjoint in women than men.
Approximately 400,000 people are living with MS in the United States
todaywith 200 more people diagnosed every week. MS is not directly
 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
Sto. Tomas Branch
Organization of Electronics and Communications
Engineering Students

hereditary, although genetic susceptibility plays a part in its

development, and MS is not contagious or infectious.

The cause of MS is not clearly notorious, but it likely

encompasses a combination of genetic susceptibility and an assumed
non-genetic trigger (e.g., viral infection, low vitamin D levels) that
together result in a self-sustaining autoimmune disorder that leads to
recurrent immune attacks on the central nervous system (Luzzio,
2017). Involvement of environmental factors in the etiology is
supported by the geographic variations in the incidence of MS.

MS is diagnosed on the basis of clinical findings and supporting

evidence from ancillary tests, such as magnetic resonance imaging
(MRI) of the brain and cerebrospinal fluid examination. The most
common test used nowadays is the MRI. Magnetic Resonance Imaging
(MRI) is a medical imaging technique that permits the detailed
visualization of internal anatomical structures in living human subjects.
In todays clinical settings, MRI has become a standard diagnostic tool,
and the increased availability of imaging techniques permit the routine
scanning of patients to detect a variety of tumors, lesions and
abnormalities in a non-invasive way as reported by Ozkan et al. MRI
has proved to have sensitivity perhaps 10 times greater than that of
Computerized Tomography (CT) in detecting MS lesions. The most
common MRI technique used for diagnostic studies is based on the
magnetic resonance of hydrogen nuclei. Since water is by far the most
common source of hydrogen nuclei in living tissue, it is likely that the
water content of tissue produces most of the signal seen on the scans
as reported by Paty et al.
 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
Sto. Tomas Branch
Organization of Electronics and Communications
Engineering Students

With these, the proponents came up with the idea of creating a

system by which quantification of the severity of the disease through
estimation of MS lesion volume via MR imaging is vital for the
diagnosis, understanding and monitoring the disease and its
treatment. This will show a methodology for the detection of MS
lesions with modest operator involvement using intensity-based
techniques.

Project Description

Multiple Sclerosis (MS) is a disease of the Central Nervous

System, i.e. the brain and the Spinal Cord. Magnetic Resonance
Imaging (MRI) is a medical imaging technique proven to be a
sensitive method for monitoring the progression and changes of
this disease due to treatment protocols. Quantification of the
severity of the disease through estimation of MS lesion volume via
MR imaging is vital for understanding and monitoring the disease
and its treatment.

This project entitled Development of Quantification

Technique in the Detection and Area Measurement of Multiple
Sclerosis Brain Lesions using Image Processing in Magnetic
Resonance Images presents a refined methodology called Lesion
Detection System for the detection of MS lesions with modest
operator involvement using intensity-based techniques. The
proposed system consists of two major functions, segmentation and
calculation. The problem of segmentation consists of the
 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
Sto. Tomas Branch
Organization of Electronics and Communications
Engineering Students

identification and extraction of substructures of the brain.

Calculations involve the area measurements of the results obtained
by the segmentation function.

Statement of the Problem

Multiple Sclerosis is a debilitating and progressive disease that

results in a variety of symptoms from blurred vision to severe muscle
weakness and degradation depending on the area of the CNS, which is
affected. MS lesions, sometimes referred to as plaques, are caused by
a breakdown in the myelin sheath, a soft, white, fatty material that
provides for the rapid transmission of nerve impulses along the nerve
fibers of the brain and Spinal Cord. The inherent heterogeneity of
lesions, which is reflected on MR images, causes some of the
challenges encountered while attempting to separate lesions from
healthy brain tissue and Cerebro-Spinal fluid (CSF) compartments
using segmentation approaches based on signal intensity
characteristics alone. The proposed study presents a new method of
using the intensity characteristics of the MRI to detect lesions. One of
the future enhancements of this research is the presentation of a tool
for the physicians to accurately track the progress of MS patients.

Specifically, it sought to answer the following questions:

1. How will the brain lesions be detected and computed?

2. How will the developed quantification system be designed?
3. How will the magnetic resonance images be used in the system?
 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
Sto. Tomas Branch
Organization of Electronics and Communications
Engineering Students

4. How will the validity and the accuracy of the device be tested?
5. How will the developed system be more significant compared to
the existing methodology?

Research Framework

Theoretical Framework

Multiple sclerosis (MS) is a disease which affects the brain

and the spinal cord. It mostly affects myelin or white matter. Myelin
is the insulation on the nerve cells. If you remove or damage
myelin, the nerve cells can't send signals to each other. This causes
symptoms such as weakness, vision problems, numbness, or poor
coordination. Based on Dr. Lindseys Multiple Sclerosis Website,
there are no known causes of this disease. Moreover, he added
that,

"The leading theory now is that it is an

autoimmune disease. The immune system, which
is supposed to fight infections, for some reason
starts to attack myelin instead. There is a lot of
evidence for this, and most of the treatments for
MS are aimed at the immune system. Other ideas
are that MS is the result of a chronic infection or
some defect in the myelin which causes it to be
unstable and break down.

In determining the existence of this disease, a process called

Magnetic Resonance Imaging (MRI) is such an important factor. It is
a type of scan that uses strong magnetic fields and radio waves to
produce detailed images of the inside of the body. According to Prof.
 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
Sto. Tomas Branch
Organization of Electronics and Communications
Engineering Students

Dr. Hans H. Schild, author of MRI Made Easy, the basic concept of
MRI is explained as follows:

Magnetic resonance imaging (MRI) makes use of

the magnetic properties of certain atomic nuclei.
An example is the hydrogen nucleus (a single
proton) present in water molecules, and
therefore in all body tissues. The hydrogen nuclei
behave like compass needles that are partially
aligned by a strong magnetic field in the scanner.
The nuclei can be rotated using radio waves, and
they subsequently oscillate in the magnetic field
while returning to equilibrium. Simultaneously
they emit a radio signal. This is detected using
antennas (coils) and can be used for making
detailed images of body tissues.

As the design project aims to use the magnetic resonance

images to calculate the volume of MS brain lesions, image
processing is applied. As D Dutta Majumder stated on his cybernetic
approach about the unified framework for pattern recognition,
computer vision and artificial intelligence in fifth generation
computer systems:

For evolution to the Fifth Generation Computer

Systems (FGCS) as defined by Japanese and other
scientists, some of the things required are realisation
and implementation of the advances in pattern
recognition and its sub-areas, not only to achieve the
man-machine interface with a natural mode of
 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
Sto. Tomas Branch
Organization of Electronics and Communications
Engineering Students

communication, but also the realisation of basic

mechanism of inference, association and learning,
which are inherent in pattern recognition and vice
versa for the core functions of FGCS. The next
generation computers will be knowledge-based
systems which is a sub-domain of artificial intelligence
(AI) techniques, and so AI provides the essential link
between the above mentioned pattern recognition
domains and different application systems.

These statements explained the basic theory of the MRI and image
processing.

Project Objectives
 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
Sto. Tomas Branch
Organization of Electronics and Communications
Engineering Students

The researchers developed a quantification technique that will detect

the lesions and compute their volume through the use of image
processing techniques in MRI. The study leads to the following
objectives.

Specific Objectives:
1. To develop a refined semi-automatic technique for detecting
lesions and computing their volumes.
2. To design a system of the two major functions, segmentation and
calculation of lesions.
3. To design a system that will use processing of magnetic
resonance images.
4. To prove the validity and accuracy of the system.
5. To assess the significance difference of the developed system to
the existing technique.

Scope and Limitation

This project is about Multiple Sclerosis Brain Lesions Diagnosis

from Highly Processed Magnetic Resonance Images. The concept of
this project is to develop and provide a simulation of the detection and
measurement of multiple sclerosis brain lesions using

The design project can be used in medical field by which the

neurologists can detect and diagnose the situation of a patient with
multiple sclerosis brain lesions from a highly processed magnetic
resonance images. This development uses MATLAB for the simulation
and the generation of the result. It needs technical skills and ability of
 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
Sto. Tomas Branch
Organization of Electronics and Communications
Engineering Students

engineers with the help of the neurologists for the factual analysis of
data.

Significance of the Study

To the Community. This proposed project aspires to help the whole

community which rely on the basis of just medical diagnosis in the
possibility of occurrence of this medical condition. In addition, this will
surely help the local government units and also medical
establishments to have more developed application concerning the
condition.

To the Patients and their Parents. This will help the patients and
their parents to be more aware of their condition, be able to detect the
situation of the ailment with the use of the developed application with
the engineering field.

To the Neurologists. With the advancement of technologies present

nowadays, this project aims to help the doctors, especially the
neurologists, in the diagnosis of the ailment with the help of the
simulation in this project that enables them to detect and measure
multiple sclerosis brain lesions from highly processed magnetic
resonance images.

To the Students. The study regarding Multiple Sclerosis Brain Lesions

has been one major concern of the students today, especially in the
Medical field. This targets to help the students, also from engineering
field, to be knowledgeable and aware enough with the diagnosis of the
ailment.
 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
Sto. Tomas Branch
Organization of Electronics and Communications
Engineering Students

To the Future Researchers. The project will serve as a future

reference for researchers who will be dealing with studies related to
Multiple Sclerosis Brain Lesions Diagnosis from Highly Processed
Magnetic Resonance Images. This will also serve as a foundation for
building an innovation in the field of electronics and biomedical in a
fast changing community.

Research Methodology

Research Design
The researchers used experimental research method in the
project. Specific information about the problem, the multiple sclerosis
brain lesions, the medical diagnosis concerning about this and the
techniques for the quantitative analysis of MR Images are described
and provided which led to the idea of making the proposed project. The
researchers also scrutinized, discussed and explained the concepts
regarding important factors that an MS patient should understand.

Sources of Data
The researchers used secondary materials in gathering
information. The researchers used related medical diagnosis and
information identified by the neurologists in the development of the
proposed project. Secondary data includes researches of related
studies from related thesis and Internet.

Research Instruments
The researchers will need to have mindfulness and awareness in
technical aspects regarding the Multiple Sclerosis Brain Lesion and how
 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
Sto. Tomas Branch
Organization of Electronics and Communications
Engineering Students

this biomedical field be enhanced and developed with the application

of engineering sciences and simulation. The proponents will use a
certain development tool in creating this essential part of the
technology.
Also, the group will also use MATLAB software in order to achieve
the goals of detection and measurement of Multiple Sclerosis brain
Lesion.