1. An apparatus for generating a customized patient report comprising: a memory for storing a plurality of patient specific attributes and a plurality of user defined rules, said attributes including patient specific medical image data; a stored program configured to apply a rule to a corresponding attribute, said stored program configured to allow an end user to at least one of create, edit, and add at least one of said attributes and said user defined rules; a processor operating with said stored program for processing to establish a conclusion to said rule; and an output device configured to generate the customized patient report having said conclusion in text format.