A brief review of the development of computer analysis of chest X-rays at the University of Missouri - Columbia is given. Chest analysis by computer has developed from cardiac silhouette shape and size analysis to lung field analysis in the form of image texture algorithms. The overriding problem is the variability in the normal human anatomy, especially as it is presented in radiographs. A major effort has been made to produce and verify valid data bases of substantial size. The diagnostic effectiveness of digital image analysis algorithms has been the utmost concern. Success has been achieved on a small scale relative to the total area of automated chest X-ray analysis.