In the past decades, technical advances have allowed for the collection and storage of more types and larger quantities of medical data. The increase in the volume of existing medical data has increased the need for processing and analyzing such data. Medical data holds information that is invaluable for diagnostic as well as treatment planning purposes. Presently, a large portion of the data is not optimally used towards medical decisions because information contained in the data is inaccessible through simple human inspection, or traditional computational methods. In the field of trauma medicine, where caregivers are frequently confronted with situations where they need to make rapid decisions based on large amounts of information, the need for reliable, fast and automated computational methods for decision support systems is stringent. Such methods could process and analyze, in a timely fashion, all available medical data and provide caretakers with recommendations/predictions for both patient diagnostic and treatment planning. Presently however, even extracting features that are known to be useful for diagnosis, like presence and location of hemorrhage and fracture, is not easily achievable in automatic manner. Trauma is the main cause of death among Americans age 40 and younger; hence, it has become a national priority. A computer-aided decision making system capable of rapidly analyzing all data available for a patient and forming reliable recommendations for physicians can greatly impact the quality of care provided to patients. Such a system would also reduce the overall costs involved in patient care as it helps in optimizing the decisions, avoiding unnecessary procedures, and customizing treatments for individual patients. Among different types of trauma with a high impact on the lives of Americans, traumatic pelvic injuries, which often occur in motor vehicle accidents and in falls, have had a tremendous toll on both human lives and healthcare costs in the United States. The present project has developed automated computational methods and algorithms to analyze pelvic CT images and extract significant features describing the severity of injuries. Such a step is of great importance as every CT scan consists of tens of slices that need to be closely examined. This method can automatically extract information hidden in CT images and therefore reduce the time of the examination. The method identifies and signals areas of potential abnormality and allows the user to decide upon the action to be taken (e.g. further examination of the image and/or area and neighboring images in the scan). The project also initiates the design of a system that combines the features extracted from biomedical signals and images with information such as injury scores, injury mechanism and demographic information in order to detect the presence and the severity of Traumatic Pelvic Injuries and to provide recommendations for diagnosis and treatment. The recommendations are provided in form of grammatical rules, allowing physicians to explore the reasoning behind these assessments.

In recent decades, more types and quantities of medical data have been collected due to advanced technology. A large number of significant and critical information is contained in these medical data. High efficient and automated computational methods are urgently needed to process and analyze all available medical data in order to provide the physicians with recommendations and predictions on diagnostic decisions and treatment planning. Traumatic pelvic injury is a severe yet common injury in the United States, often caused by motor vehicle accidents or fall. Information contained in the pelvic Computed Tomography (CT) images is very important for assessing the severity and prognosis of traumatic pelvic injuries. Each pelvic CT scan includes a large number of slices. Meanwhile, each slice contains a large quantity of data that may not be thoroughly and accurately analyzed via simple visual inspection with the desired accuracy and speed. Hence, a computer-assisted pelvic trauma decision-making system is needed to assist physicians in making accurate diagnostic decisions and determining treatment planning in a short period of time. Pelvic bone segmentation is a vital step in analyzing pelvic CT images and assisting physicians with diagnostic decisions in traumatic pelvic injuries. In this study, a new hierarchical segmentation algorithm is proposed to automatically extract multiplelevel bone structures using a combination of anatomical knowledge and computational techniques. First, morphological operations, image enhancement, and edge detection are performed for preliminary bone segmentation. The proposed algorithm then uses a template-based best shape matching method that provides an entirely automated segmentation process. This is followed by the proposed Registered Active Shape Model (RASM) algorithm that extracts pelvic bone tissues using more robust training models than the Standard ASM algorithm. In addition, a novel hierarchical initialization process for RASM is proposed in order to address the shortcoming of the Standard ASM, i.e. high sensitivity to initialization. Two suitable measures are defined to evaluate the segmentation results: Mean Distance and Mis-segmented Area to quantify the segmentation accuracy. Successful segmentation results indicate effectiveness and robustness of the proposed algorithm. Comparison of segmentation performance is also conducted using both the proposed method and the Snake method. A cross-validation process is designed to demonstrate the effectiveness of the training models. 3D pelvic bone models are built after pelvic bone structures are segmented from consecutive 2D CT slices. Automatic and accurate detection of the fractures from segmented bones in traumatic pelvic injuries can help physicians detect the severity of injuries in patients. The extraction of fracture features (such as presence and location of fractures) as well as fracture displacement measurement, are vital for assisting physicians in making faster and more accurate decisions. In this project, after bone segmentation, fracture detection is performed using a hierarchical algorithm based on wavelet transformation, adaptive windowing, boundary tracing and masking. Also, a quantitative measure of fracture severity based on pelvic CT scans is defined and explored. The results are promising, demonstrating that the proposed method not only capable of automatically detecting both major and minor fractures, but also has potentials to be used for clinical applications.