A computerized method for the detection and characterization of disease in an image derived from a chest radiograph, wherein an image in the chest radiograph is processed to determine the ribcage boundary, including lung top edges, right and left ribcage edges, and right and left hemidiaphragm edges. Texture measures including RMS variations of pixel values within regions of interest are converted to relative exposures and corrected for system noise existing in the system used to produce the image. Texture and/or geometric pattern indices are produced. A histogram(s) of the produced index (indices) is produced and values of the histogram(s) are applied as inputs to a trained artificial neural network, which classifies the image as normal or abnormal. In one embodiment, obviously normal and obviously abnormal images are determined based on the ratio of abnormal regions of interest to the total number of regions of interest in a rule-based method, so that only difficult cases to diagnose are applied to the artificial neural network.