Flexible determination of image interpretation strategies is made poss
ible by reasoning on the state of the interpretation process. The stat
e is here described as a string of attributed symbols denoting images,
descriptions, actions and patterns of actions. Goals of the interpret
ation are specified by Conditional Attributed Rewriting Systems. An in
terpreter exploits these systems to interpret the image, i.e., to dete
rmine the evolution of the state from the initial state to the final i
nterpretation. An example from liver biopsy interpretation is introduc
ed, its results contrasted with those of human interpretations and the
automatic interpreter efficacy commented on.