IMAGING CONNECTORS
Images, Studies & Instances
5 of 8Discover, retrieve, stream and represent imaging data across the Patient, Study, Series and Instance DICOM hierarchy using both classic DICOM and DICOMweb.
DICOM ClassicDICOMwebFHIR ImagingOrthancQIDO-RSWADO-RSSTOW-RSInteroperableScalable
DICOM Hierarchy
1
Patient
One or more imaging studies
2
Study
Diagnostic episode or imaging procedure
3
Series
Images of the same protocol / body part
4
Instance
Individual DICOM object / image
Key identifiers include Patient ID, StudyInstanceUID, SeriesInstanceUID, SOPInstanceUID, accession number, modality and study date.
Discovery (Query)
DICOM Classic — C-FIND
Query patient / study / series / instance
Return matching attributes
Use levels PATIENT, STUDY, SERIES, IMAGE
Supports filtered queries
DICOMweb — QIDO-RS
RESTful query for studies, series and instances
JSON or XML response
Pagination, filtering and sorting
Supports include fields and key attributes
Retrieve & Stream
DICOM Classic
C-MOVE: server-to-destination transfer
C-GET: retrieve to requester
C-STORE: receive instances
Compressed transfer syntaxes and batching
DICOMweb — WADO-RS
Retrieve instances or frames over HTTP
Supports rendered views, thumbnails and metadata
Range requests and byte serving
Viewer-optimized streaming
Ingestion (STOW-RS)
Store images to Mediloop / Orthanc
Single or multipart upload
Return instance UIDs in response
Validate metadata and required identifiers
Support modality push, mobile capture and external archive imports
Preserve source-system and upload provenance
FHIR ImagingStudy Mapping
| DICOM / source field | FHIR target |
|---|---|
| StudyInstanceUID | ImagingStudy.identifier (DICOM system) |
| Accession Number | ImagingStudy.identifier (accession system) |
| Patient demographics | ImagingStudy.subject (Patient) |
| Referring physician | ImagingStudy.referrer (Practitioner) |
| Modality / series | ImagingStudy.series[] |
| Reports | DiagnosticReport (linked) |
| Instances / SOPInstance | ImagingStudy.series[].instance[] |
Metadata & Attributes
| Category | Examples |
|---|---|
| Patient | PatientID, Name, DOB, sex |
| Study | StudyDate, StudyDescription, accession number, institution, referring physician |
| Series | Modality, BodyPartExamined, ProtocolName, SeriesDescription |
| Instance | SOPClassUID, SOPInstanceUID, InstanceNumber, ImageType, Rows/Columns, PixelSpacing |
| Technical | TransferSyntaxUID, SeriesInstanceUID, bits allocated, photometric interpretation |
| Other | Contrast bolus agent, positioning, manufacturer, software versions |
Derived Objects & Key Images
Key images / thumbnails
Preview and selected reference frames
MPR objects
Multi-planar reconstruction objects and derived series
3D volumes & surfaces
3D-derived artifacts and rendering references
Segmentation objects
DICOM SEG or other segmentation outputs
Structured reports
DICOM SR linked back to the parent study
AI results
AI annotations stored with model/version provenance
Duplicate Detection
Detect exact duplicates using StudyInstanceUID / SeriesInstanceUID / SOPInstanceUID
Fallback matching using patient + accession + study date + modality + description
Configurable fuzzy-matching rules
Merge or link duplicates across PACS / VNA where policy allows
Keep original provenance and source references
Partial Studies
Handle studies with missing series or instances
Track expected vs received instance counts
Use timeouts and completion rules
Notify consumers when study becomes complete
Reconcile late-arriving instances automatically
Progressive Loading
1
Open study
User requests study
2
Query metadata
QIDO-RS / C-FIND
3
Show preview
Display key images / thumbnails
4
On-demand retrieve
WADO-RS / C-MOVE
5
Stream frames
Progressive viewer delivery
6
Cache
Optimize repeated access
Key Capabilities
Complete DICOM hierarchy support
Dual-stack DICOM Classic and DICOMweb
High-performance retrieval and streaming
Bulk ingestion with STOW-RS
FHIR ImagingStudy alignment
Metadata synchronization
Duplicate detection and reconciliation
Secure and scalable architecture
Common Use Cases
Clinical diagnostic workflows
Prior-study retrieval
Cross-organizational sharing
AI / CAD image ingestion
Research and longitudinal archives
Mobile and remote imaging