Understanding DICOM: A Practical Guide for Healthcare Software Teams
What is DICOM?
DICOM (Digital Imaging and Communications in Medicine) is the international standard for storing, transmitting, and managing medical imaging data. If you work with any healthcare software that touches imaging—X-rays, CT scans, MRIs, ultrasounds—you will encounter DICOM.
Why DICOM Matters
Before DICOM, medical imaging systems were proprietary islands. An X-ray taken on one vendor's equipment could not be viewed on another's. DICOM changed this by establishing:
Key DICOM Concepts
Information Object Definition (IOD)
Each type of medical image (CT, MR, X-ray) has a defined structure. This IOD specifies what data must be included—patient name, study date, image parameters, pixel data.
Service-Object Pair (SOP) Classes
DICOM defines standard services that can be performed on objects:
Transfer Syntax
How pixel data is encoded and compressed. Different systems support different transfer syntaxes, which can cause interoperability issues.
Testing DICOM Systems
When testing DICOM implementations, focus on:
Conformance Does the system implement DICOM services correctly? Does it handle all required attributes?
Interoperability Can it communicate with other DICOM systems? Test with multiple vendors and versions.
Edge Cases How does it handle missing optional fields? Unusual character sets? Very large images?
Performance How fast can it store and retrieve images? What happens under load?
Free Resources
The full DICOM standard is available free at dicom.nema.org. While comprehensive, it is also dense. Start with Part 1 (Overview) and Part 10 (Media Storage).
Conclusion
DICOM is foundational knowledge for healthcare software teams. Understanding its basics helps you build better integrations, write more effective tests, and communicate with clinical stakeholders.