In recent years, medical images have played an essential role in diagnosis, treatment, and training areas. Thus, any advancement in this field can help doctors in diagnosing. On the other hand, statistical process control (SPC) is now widely used in monitoring healthcare processes. In this research, using the image processing techniques and feature extraction methods (two-dimensional discrete wavelet), we propose some multivariate control charts to diagnose the type of bone marrow of the patients suspected of bone marrow metastasis in the pelvic region with early breast tumors. For this, 76 features (energy and histogram of oriented gradient) are extracted from the image. Next, using the GA, six features are selected and constitute a feature vector. Based on the feature vector, Hotelling’s T2 multivariate control charts are developed. Moreover, considering the high sensitivity of the classic estimators to outliers and …