DICOM

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DICOM (Digital Imaging and Communications in Medicine) is the international standard for storing, transmitting, and managing medical imaging information and associated data.

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It enables interoperability between imaging devices and systems from different manufacturers across radiology, cardiology, oncology, and other specialties.

DICOM is both:

A file format: used to store medical images with embedded patient and imaging metadata.
A communication protocol: that governs how devices such as CT, MRI, ultrasound, PACS, and RIS exchange imaging data over a network.

Published by: National Electrical Manufacturers Association (NEMA) in coordination with the American College of Radiology (ACR).

Key Objectives

Standardize image format and metadata
Ensure interoperability between imaging equipment
Support workflow integration (e.g., modality worklists, image storage, query/retrieve)
Maintain data fidelity, traceability, and patient safety

DICOM File Structure

Component	Description
Header	Contains metadata such as patient name, study ID, modality, institution, and acquisition parameters
Pixel Data	Actual image data (can be 2D, 3D, or 4D, compressed or uncompressed)
DICOM Tags	Each metadata element is encoded using unique tags (e.g., (0010,0010) = Patient Name)

File extension: .dcm

Core DICOM Services

Service	Function
Store (C-STORE)	Sends image from modality to PACS
Query/Retrieve (C-FIND / C-MOVE / C-GET)	Find and pull images from archive or PACS
Modality Worklist (MWL)	Sends scheduled patient information to imaging devices
Storage Commitment	Verifies successful archival of image
Print	Enables printing on DICOM-compliant printers
Modality Performed Procedure Step (MPPS)	Sends exam status updates to RIS/PACS
Structured Reporting (SR)	Encodes reports in machine-readable format
DICOMweb	RESTful web services for DICOM (WADO-RS, QIDO-RS, STOW-RS) for browser/cloud access