A couple of steps have to be taken for proper lung image retrieval. The first steps can not be done in an automatic way. A medical doctor (MD) has to supply the necessary information. Only like this, a proper evaluation of the retrieval quality is possible. Tools have to be developed to make this interactive process as easy as possible for the MD. At the University Hospitals of the Geneva a set of tools is the CasImage program that is a collection of medical cases including medical images, especially for teaching but that could also be used for case-based diagnostics.