The March 2024 SIIM webinar delved into the intricacies of DICOM toolkits, spotlighting their role in ensuring seamless medical imaging integration. Spearheaded by industry experts Mr. Keith Horaska, Technical Engineer at Sectra, and Mr. Andrew Volkening, VP of Product at Mach7 Technologies, the session provided invaluable insights into the functionalities, use cases, and best practices of two primary DICOM toolkits: DCMTK and DCM4CHE.

This opportunity, initiated by The Academy for Radiology & Biomedical Imaging Research, served as an eye-opener, bridging the gap between early career investigators and seasoned researchers across various disciplines. Engaging in numerous virtual sessions, I explored the intricacies of advocacy—a concept that initially seemed confusing to me. Through workshops on NIH funding, grant applications, and career development led by distinguished leaders in the field, I gained invaluable insights into the advocacy process. This digital engagement phase laid a robust foundation, enhancing my understanding and appreciation of the critical role advocacy plays in securing research funding and advancing the imaging informatics field.

What are DCMTK and DCM4CHE?

DCMTK (DICOM Toolkit) is an open-source command-line interface (CLI) tool designed to facilitate communication with DICOM systems across various platforms, including Windows, Mac, and Linux. It plays a pivotal role in troubleshooting issues between vendors by offering a neutral output that helps identify the root cause of problems. DCMTK is not tied to any specific vendor, making it a versatile and reliable tool for DICOM-related tasks.

DCM4CHE is another open-source toolkit that provides a suite of tools for troubleshooting and managing DICOM workflows. With its most recent version, DCM4CHE v5, the toolkit offers enhanced functionalities and requires JDK 11 or newer for optimal performance.

Key Features and Use Cases


  • dcmdump: A tool for dumping DICOM files, now supporting color in the console, which aids in parsing efficiency by grouping data.
  • dcmmodify: Allows modification of DICOM header information, useful for fixing incorrect headers and testing changes.
  • storescp and storescu: Tools for ingesting and storing DICOM objects respectively, providing flexibility in handling DICOM data.
  • findscu: Enables querying worklists or a Query/Retrieve SCP, invaluable for

troubleshooting retrieval issues from third-party systems.


  • storescp and storescu: Similar to DCMTK’s storescp and storescu, these tools facilitate the Storage Service Class and Verification SOP class functionalities.
  • findscu: Provides SCU for various service classes, supporting query functionality using the C-FIND message.
  • DCM2XML and DCM2DCM: Tools for converting DICOM files to XML and transcoding DICOM files according to specified Transfer Syntax, respectively.

Best Practices and Tips

During the Q&A session, several practical questions were addressed:

Q: Is WireShark like dcmtk?

A: While Wireshark operates at the TCP/IP layer, dcmtk serves as a communicator between two DICOM devices, focusing on application-based communication.

Q: What tools are recommended for stress testing an archive?

A: PowerShell scripting, combined with tools like dcmmodify and scan-directories flag, can be employed for stress testing archives.

Q: Are there tools for testing a DMWL query from a modality?

A: Emulating the worklist query is more straightforward than setting up a modality worklist server.


The SIIM webinar highlighted the pivotal role of DICOM toolkits in ensuring seamless medical imaging integration. Both DCMTK and DCM4CHE offer a plethora of tools and functionalities that are indispensable for DICOM-related tasks, from troubleshooting to data manipulation and integration.

It is essential for professionals in the medical imaging industry to familiarize themselves with these toolkits and leverage their capabilities to optimize DICOM workflows. A special thanks to Mr. Keith Horaska and Mr. Andrew Volkening for their insightful presentation, shedding light on the practical aspects of mastering DICOM toolkits.

Stay tuned for more informative sessions in the SIIM Enterprise Imaging Webinar Series, and feel free to share your thoughts and questions in the comments below!

Note: This blog post is a summary of the recent SIIM webinar on Mastering DICOM Toolkits and is based on the provided notes. For more detailed information and specific use cases, please refer to the webinar recording and associated materials.

Written by

Cooper Gamble, Radiology Informatics Intern, Mayo Clinic

Publish date

Mar 29, 2024


  • Administration and Operations
  • Applications
  • Enterprise Imaging
  • PACS
  • Pathology
  • Systems Management

Media Type

  • Blog

Audience Type

  • Developer
  • Imaging IT
  • Vendor


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