1. A system for knowledge-based image computer aided detection comprising: a text interpretation system receiving an electronic patient record and outputting an assertion relevant for the electronic patient record; an annotation/detection system detects anatomical and functional structures in input images and interacts with the text interpretation system to receive the assertion and outputting annotated images based on the input images; and an imaging decision support system taking the annotated images and outputting classifications of annotated structures in the annotated images.