Introduction to DICOM Standard
Prepared by Prashant Shivaji Moghe
Digital Imaging and Communications in Medicine (DICOM) is the international standard for
handling, storing, transmitting, and displaying medical images. It was first developed in the 1980s
by the American College of Radiology (ACR) and the National Electrical Manufacturers Association
(NEMA) to address the need for interoperability between imaging equipment from different vendors.
DICOM not only defines a file format for images but also a communication protocol based on
TCP/IP. This dual nature enables seamless exchange of images and related information such as
patient demographics, study descriptions, and imaging modality details. Unlike traditional image
formats (JPEG, PNG), DICOM files embed both pixel data and metadata, ensuring that clinical
context is preserved. One of DICOM’s major strengths is its role in Picture Archiving and
Communication Systems (PACS). By standardizing image storage and retrieval, DICOM has
allowed hospitals and clinics worldwide to adopt digital workflows, moving away from film-based
radiology. Clinicians can now access images instantly, improving diagnostic speed and patient
care. Compression in DICOM supports both lossless (e.g., JPEG-LS, JPEG 2000 lossless) and
lossy methods, allowing balance between image quality and storage efficiency. Another important
aspect is DICOM’s structured reporting, enabling integration of quantitative measurements and
AI-driven analysis directly into the imaging workflow. DICOM continues to evolve with healthcare IT
trends. Recent extensions include support for 3D/4D imaging, whole-slide microscopy, and
web-based access (DICOMweb). Security remains a challenge, with encryption, authentication, and
HIPAA/GDPR compliance becoming increasingly important in clinical settings. In summary, DICOM
has become the backbone of modern medical imaging. Its standardization ensures interoperability,
long-term data accessibility, and integration with cutting-edge technologies like artificial intelligence.
Future developments will further enhance its role in precision medicine and global healthcare
connectivity.
