Thoracic imaging constitutes more than one-third of all medical imaging performed in the United States. Despite the substantial impact of computer technology in other areas of imaging, conventional film-screen acquisition systems still provide the bulk of projectional chest radiography. The successful implementation of digital technology in thoracic imaging requires that the standards of current film-screen methods for both diagnostic accuracy and efficient data management be preserved. This article addresses the technical and clinical aspects of film digitization and storage phosphor technology, which are the two digital acquisition systems in widest application. Scanned projection radiography, which may now be applied to computed radiography systems, is also discussed. Finally, some of the issues surrounding the implementation of picture archiving and communication systems for thoracic imaging are addressed.