Inventory of Health Care Information Standards. DICOM Standard. NEMA PS3.x - 1992, 1993, 1995


Contact For More Information

DICOM Secretariat: NEMA

Mr. David Snavely, 1300 North 17th Street, Suite 1847, Rosslyn, VA 22209


DICOM Liaison Working Group Secretariat: American College of Radiology

Mr. James Potter, 1891 Preston White Drive, Reston, VA 22091


DICOM Structured Reporting Secretariat: College of American Pathologists

Ms. Karen Kudla, 325 Waukegan Road, Northfield, IL 60093-2750


DICOM Visible Light Working Group Secretariat: Am. Soc. of Gastro. Endoscopy

Dr. Louis Korman, Washington VA Medical Center


DICOM ANSI HISB Liaison: W. Dean Bidgood, Jr., M.D., M.S.

Box 3321, Duke University Medical Center, Durham, NC 27710


Description of Standard

DICOM specifies a generic digital format and a transfer protocol for biomedical images and image-related information. The specification is usable on any type of computer and is useable to transfer images over the Internet. DICOM interfaces are available for nearly all types of imaging devices sold by all of the leading vendors of radiology imaging equipment. DICOM is now being adopted for use outside of radiology (for example, in pathology, internal medicine, veterinary medicine, and dentistry).

The most commonly used diagnostic and therapeutic biomedical image types are fully covered by DICOM. DICOM has been adopted by the U.S. Veterans Affairs Administration and the U.S. Armed Forces.

DICOM enables interchange of text information, coded information, measurements, images, and other binary data. The systems domain focus is on all aspects of image management. Interfacing with other text-based information systems is also specified. Trial implementation of a new structured report interface will begin in January, 1997.

Readiness of Standard

All radiology image specifications of DICOM are fully implementable. The visible light (color) image types and the structured reporting interfaces will be available for trial implementation in January, 1997. Additional draft specifications for radiation oncology, PostScript™ Print management, Positron Emission Tomography, image data compression, security, image presentation (standardized display) parameters are under development at the time of this writing.

DICOM is an implementable standard. There is no official implementation guide. Public domain software implementations are available on the Internet. Several companies offer implementation software "tool kits" for sale. Further information about DICOM resources may be obtained on the NEMA WWW site: (

Indicator of Market Acceptance

DICOM is the dominant non-prominent data interchange message standard in biomedical imaging. All major radiology equipment vendors have implemented the standard. Acceptance is growing rapidly outside of radiology. Interconnectivity among many vendors has been demonstrated to the public in many international meetings since 1992.

Level of Specificity

DICOM is a highly specific and explicit specification. The standard specifies all data interchange parameters from hardware factors (industry standards adopted) up through the bit/byte stream, services, protocols, to the domain knowledge layer. A very practical and useful level of interoperability can be achieved with the standard. The need for local configuration agreements is minimized. The SNOMED DICOM Microglossary™ is the preferred coding system -to- message data element Mapping Resource. SNOMED (Systematized Nomenclature of Human and Veterinary Medicine, © College of American Pathologists) and LOINC (Logical Observation Identifiers, Names, and Codes) database are the preferred coding systems. DICOM also supports locally-defined (or private) coding systems.

Relationships With Other Standards

DICOM has a close relationship to the HL7 Standard in the area of Imaging System - Information System interfacing. DICOM has entered into standards developing partnership with the SNOMED Authority of the College of American Pathologists. Ultrasound, cardiovascular, and other DICOM measurement codes are being developed in close cooperation with the LOINC Committee. Internationally, DICOM is compatible with the CEN/TC 251 WG4 MEDICOM Standard and the Japanese JIRA and MEDIS-DC Standards for network interchange of images and image-related information.

Enhancement of the Information System - Imaging System interface specifications of DICOM and related standards is underway at the time of this writing. DICOM offers advanced capabilities for management of binary data objects (such as images) that are not available in the current versions text-based data interchange standards (HL7 and X-12).

Identifiable Costs

The printed specification of the DICOM Standard is available from NEMA for approximately $300. Implementation training is available from private consulting and training companies. Due to the complexity of imaging technology, the DICOM specification is complex. Significant training is required in order to write compatible software. However, the availability of software implementation "tool kits" from several commercial sources has greatly simplified the implementation of DICOM for most vendors.