DICOMDigital Imaging and Communications in Medicine

What it is

DICOM (Digital Imaging and Communications in Medicine) is the international standard for medical images and related information. It is developed by the DICOM Standards Committee, an independent international organization, with NEMA as secretariat; MITA, a division of NEMA, manages the standard. ISO recognizes it as ISO 12052.

It was born in 1993 as the third version of the ACR-NEMA 300 standard (the earlier ones date from 1985 and 1988), which is why people still speak of "DICOM 3". Today it is maintained through editions released several times a year; as of October 2026, the current one is 2026d. The text is split into parts (PS3.1 to PS3.22), for example Part 3 (object definitions), Part 10 (file format) or Part 18 (web services).

How it works

DICOM defines both the format and the services:

• Every object (an image, a structured report, a dose record) combines coded metadata and pixel data, and identifies patient, study, series and instance with unique identifiers.
• Network services allow objects to be stored, queried and retrieved, or a modality to request its worklist.
• DICOMweb (Part 18) offers the same services over HTTP: QIDO-RS to search, WADO-RS to retrieve and STOW-RS to store.

According to the committee, DICOM is implemented in almost every radiology, cardiology imaging and radiotherapy device, and increasingly in ophthalmology and dentistry.

Common misconceptions

• "DICOM compatible" says nothing on its own. What matters is the device's conformance statement (Part 2): which services and objects it supports, and in which role.
• DICOM is not only about images: it also covers structured reports, radiation dose records and other objects.
• DICOM does not replace clinical messaging. The order usually reaches the radiology system through HL7 v2, and IHE profiles coordinate both worlds.
• "DICOM 3" does not tell you what a device supports. Since the standard is updated several times a year, cite the edition or the specific part.