Our well designed PI-PACS system can be extended with a Chest CAD (Computer Aided Detection) option to serve as a PACS with a decision support system intended for hospital use, especially in pulmonary care. The primary use of the Chest CAD system is automatic evaluation of chest X-Ray images that support radiologists during the evaluating procedure. The CAD system’s main goal is to find as many true lesions and infiltrated areas as possible. PI-PACS Chest CAD has got high sensitivity besides reasonable false positive rate which means a definite help to the examiner.