This disclosure relates to detecting visual findings in anatomical images. Methods comprise inputting anatomical images into a neural network to output a feature vector and computing an indication of visual findings being present in the images by a dense layer of the neural network that takes as input the feature vector and outputs an indication of whether each of the visual findings is present in the anatomical images. The neural network is trained on a training dataset including anatomical images, and labels associated with the anatomical images and each of the visual findings. The visual findings may be organised as a hierarchical ontology tree. The neural network may be trained by evaluating the performance of neural networks in detecting the visual findings and a negation pair class which comprises anatomical images where a first visual finding is identified in the absence of a second visual finding.