Viewing Scans (DICOM)

Before you open a scan

Data concerning health is special category personal data under UK GDPR, defined as personal data related to the physical or mental health of a person, including information about healthcare received; patient images with identifiers fall in this category. (Information Commissioner's Office (ICO), 'What is special category data?', source)
Pseudonymised data remains personal data in the hands of anyone holding the additional information and stays in scope of data protection law; only effective anonymisation takes data outside it. (ICO anonymisation and pseudonymisation guidance (under review following the Data (Use and Access) Act 2025), source)
DICOM de-identification must cover both header attributes (e.g. Patient's Name, Birth Date and Study Date are listed for removal/replacement) and identifying information burned into pixel data or overlays; the standard's basic profile does not guarantee that all identifying information is removed. (DICOM Standard PS3.15 Annex E (Attribute Confidentiality Profiles), NEMA, source)
Several free viewers state they are not medical devices and must not be used for diagnosis: MicroDicom (no CE mark or FDA approval; not for clinical purposes), OsiriX Lite (not certified for primary diagnosis), 3D Slicer (not FDA approved, research use), IMAIOS (not CE or FDA approved). Primary diagnosis should use software certified for that purpose. (Developer statements (MicroDicom, Pixmeo, 3D Slicer, IMAIOS), source)
DICOM files can carry malicious content: CISA reported an out-of-bounds write in MicroDicom DICOM Viewer (CVE-2025-5943) exploitable if a user opens a malicious DICOM file, advising updating and not opening DICOM files from untrusted sources; RadiAnt's 2026.1 release likewise fixed a vulnerability in JPEG pixel-data handling. Keep viewers updated. (CISA ICS Medical Advisory ICSMA-25-160-01 (June 2025); Medixant release note, source)
The IHE Portable Data for Imaging (PDI) profile requires patient CDs/DVDs/USB media to contain the images in DICOM format; an on-disc viewer and browser-viewable copies are optional, and a README identifying the creating institution and software is recommended. (IHE Wiki, Portable Data for Imaging, source)
Hospital procedures may require external discs to be viewed through PACS and imported via the PACS team rather than via software on the disc: NHS Greater Glasgow and Clyde guidance tells staff to cancel/ignore prompts to open or view the disc, use the PACS local-CD function, and send the disc with a request form to the PACS office for import. (NHS GGC Clinical Guideline, Radiological imaging transfer/viewing guidance (v2, reviewed July 2023; its next review date, 31 July 2026, has passed), source)
Some viewers include optional cloud sharing (e.g. Horos 'Reporting & Sharing' via HorosCloud; OsiriX Study Sharing), while others state local-only behaviour (IMAIOS: 'Your files are not uploaded to our network'; Sante: internet used only for licence validation and update checks). Check where images go before using any viewer with identifiable data. (Developer pages (horosproject.org, imaios.com, santesoft.com), source)

Patient CDs: IHE PDI makes a viewer on the disc optional; the DICOM data on the disc is the required content and can be opened in any DICOM viewer. Hospital IT policy may prohibit running executables from external media (e.g. NHS GGC guidance tells staff to cancel/ignore prompts to open or view the disc and use PACS).

To send scans to a colleague, use an approved service: see Secure Messaging & Case Sharing.

Viewers

MacNot for diagnosis

Horos

Horos open-source project; Purview named on the site as Chief Sponsor

Cost and licence: Free (donations requested); Open source (LGPL, per Horos FAQ)

Details

Where images are processed: Desktop application, images processed locally. Optional cloud features: version 4.0.1 includes a HorosCloud plugin and 'Reporting & Sharing' via the cloud (recipients download studies from the cloud).
Diagnostic use: Not stated on horosproject.org. Purview blog (Jan 2017): 'Horos has not been formally FDA-cleared for diagnosis'; suggests it may be fine 'in cases other than diagnosis'.
Anonymisation: Not documented on the pages checked (not verified).
Spine-relevant features: Not listed on the home page checked.
Still maintained: Site advertises Horos 4.0.1 for Apple Silicon and macOS 26 Tahoe (no release date given). GitHub releases page shows latest build tagged 20240407 (April 2024).

Note: macOS only; not FDA-cleared for diagnosis (sponsor statement); optional cloud sharing would move identifiable images off the computer; release date of 4.0.1 not stated.

Developer page →Source checked

Checked 6 Nov 2026

MacDiagnostic use not stated

Miele-LXIV

Alex (Alessandro) Bettarini

Cost and licence: US$29.99 on the Mac App Store; Open source (64-bit fork of the 32-bit OsiriX project, begun 2014), sold via Mac App Store

Details

Where images are processed: Desktop application; App Store privacy label (self-reported): 'Data Not Collected'.
Diagnostic use: No developer statement on diagnostic or clinical use found on the App Store listing.
Anonymisation: Not mentioned.
Spine-relevant features: 3D views, thick-slab and MPR rendering (from version history).
Still maintained: Yes: version 9.54 dated 2 Oct (year not shown, notes 'Validated with macOS 27', so 2026 inferred); requires macOS 12+.

Note: macOS only; no regulatory statement; developer GitHub page could not be retrieved.

Developer page →Source checked

Checked 6 Nov 2026

MacNot for diagnosis

OsiriX Lite

Pixmeo (Switzerland)

Cost and licence: Free; Proprietary (free demo version of OsiriX MD)

Details

Where images are processed: Desktop application, processed locally.
Diagnostic use: Download page: 'THIS VERSION OF OSIRIX IS NOT CERTIFIED AS A MEDICAL DEVICE FOR PRIMARY DIAGNOSIS' and 'NOT INTENDED FOR PRIMARY DIAGNOSTIC, ONLY FOR SCIENTIFIC USAGE'.
Anonymisation: Not mentioned on the pages checked.
Spine-relevant features: Described as the 'complete demo' of OsiriX MD; limitations not itemised on the page checked.
Still maintained: Yes (same product line as OsiriX MD, site updated for macOS 27).

Note: macOS only; not for primary diagnosis (vendor statement); demo limitations not detailed.

Developer page →Source checked

Checked 6 Nov 2026

WindowsNot for diagnosis

MicroDicom DICOM Viewer

MicroDicom (Bulgaria)

Cost and licence: Free for non-commercial use; commercial prices not shown on the pages checked; Proprietary; free for non-commercial use, paid licence for commercial use

Details

Where images are processed: Desktop application with local study database; DICOMweb/PACS client for user-configured servers; no cloud service described.
Diagnostic use: Vendor states no CE mark, no FDA approval and no other medical device approval; 'must therefore not be used for clinical purposes or to affect patient management in any way'.
Anonymisation: DICOM Anonymizer; anonymise on export; command-line anonymisation; hide patient details when printing.
Spine-relevant features: Measurements and annotations, MPR, 3D volume rendering (STL/MP4 export), side-by-side comparison. Cobb angle and stitching not stated on pages checked.
Still maintained: Yes: new version announced 3 November 2026 (no version number given). CISA advisories ICSMA-25-160-01 (June 2025) and earlier concerned vulnerabilities fixed by updating.

Note: Windows only (macOS/Linux only via Wine or CrossOver); not a medical device - not for clinical use per vendor; keep updated (past CISA advisories on malicious DICOM files).

Developer page →Source checked

Checked 6 Nov 2026

WindowsDiagnostic use not stated

RadiAnt DICOM Viewer

Medixant (Poland)

Cost and licence: Paid; Proprietary, commercial (EULA)

Details

Where images are processed: Desktop application; local archive on the hard drive; PACS query/retrieve. No cloud processing described.
Anonymisation: DICOM anonymisation with customisable templates announced in 2024.1 beta (12 Feb 2024); presence in current stable release not confirmed on the page.
Spine-relevant features: MPR (coronal, sagittal, axial, oblique), 3D volume rendering, length and angle measurement including Cobb angle. Stitching not mentioned.
Still maintained: Yes: version 2026.1 dated 7 August 2026 (fixes an out-of-bounds write vulnerability in JPEG-compressed pixel data handling).

Note: Windows only; vendor states it is 'designed and tested specifically for the Windows platform'; on macOS only via paid CrossOver emulation, where some features may be unavailable or crash; regulatory status not verified.

Developer page →Source checked

Checked 6 Nov 2026

MacWindowsLinuxNot for diagnosis

3D Slicer

Slicer developer community (international, open source)

Cost and licence: Free; BSD-style open-source licence plus 3D Slicer Software License Agreement for binaries

Details

Where images are processed: Desktop application, processed locally.
Diagnostic use: 'NOT approved for clinical use and the distributed application is intended for research use'; '3D Slicer is NOT FDA approved'.
Anonymisation: Not checked on official pages (not verified).
Spine-relevant features: Research platform for segmentation, 3D reconstruction and analysis (DICOM features not detailed on pages checked).
Still maintained: Yes: stable 5.12.4 (builds 9-10 Sept 2026); preview 5.13.0 (5 Nov 2026). Stable has no native Apple Silicon build (preview does).

Note: Research only, not for clinical use (developer statement); complex for casual image viewing.

Developer page →Source checked

Checked 6 Nov 2026

MacWindowsLinuxDiagnostic use not stated

Aliza Medical Imaging & DICOM Viewer / Aliza MS DICOM Viewer

Aliza Medical Imaging

Cost and licence: Not stated on home page (Buy and Donate pages exist); Aliza: non-free; Aliza MS: open source (licence not named on home page)

Details

Where images are processed: Desktop application, processed locally.
Anonymisation: De-identify tool following DICOM Application Level Confidentiality Profile (PS3.15 Table E.1-1 options); random names, set name/ID, rename files.
Spine-relevant features: 2D/3D views, multi-view, MIP, fusion, registration, segmentation, measurements (no spine-specific tools stated).
Still maintained: Yes: Aliza 2.8.3 (14 Aug 2026); Aliza MS 1.10.3 (18 Aug 2026).

Note: Regulatory status not stated; geared to advanced/research users.

Developer page →Source checked

Checked 6 Nov 2026

Web browseriPad / iPhoneNot for diagnosis

IMAIOS DICOM Viewer

IMAIOS SAS (France)

Cost and licence: Free for personal and non-commercial use; Proprietary

Details

Where images are processed: Vendor states processing happens on the user's computer: 'Your files are not uploaded to our network.' (vendor claim, not independently verified).
Diagnostic use: 'is not a medical device and is not CE or FDA approved'; not for medical use.
Anonymisation: Not mentioned.
Spine-relevant features: Scrolling, windowing presets, zoom/pan, distance and angle measurement.
Still maintained: Live web service as of check date; no version date shown.

Note: Not a medical device; basic tools only; local-processing statement is the vendor's own; non-commercial use only.

Developer page →Source checked

Checked 6 Nov 2026

Web browserDiagnostic use not stated

OHIF Viewer

Open Health Imaging Foundation (programme of Massachusetts General Hospital; development by Radical Imaging)

Cost and licence: Free; paid expert support available; Open source (MIT)

Details

Where images are processed: Designed to stream images from a DICOMweb archive (PACS/Orthanc). A '/local' drag-and-drop route exists, but no official documentation found stating that local files stay in the browser; the documented 'dicomUploadEnabled' option uploads local files to the configured server.
Diagnostic use: No FDA/clinical-use statement on pages checked; GitHub states it has been the basis for FDA-cleared viewers (that status applies to those products, not OHIF itself).
Anonymisation: None documented on pages checked.
Spine-relevant features: GPU-accelerated visualisation, MPR/segmentation workflows, annotations (no spine-specific tools stated).
Still maintained: Yes: very active; v3.14.0 beta series releasing in October 2026; release notes list v3.13.0 (July 2026) as the latest release.

Note: Normally deployed by an institution in front of a server; local-file privacy behaviour not documented officially - do not assume public demo instances are suitable for identifiable images.

Developer page →Source checked

Checked 6 Nov 2026

MacWindowsLinuxWeb browserDiagnostic use not stated

Orthanc (DICOM server, for departments/research)

Sébastien Jodogne et al.; University Hospital of Liège, Osimis, Orthanc Team SRL, UCLouvain (Belgium)

Cost and licence: Free; commercial services available; Open source: server GPLv3+, plugins/viewers may be AGPLv3+

Details

Where images are processed: Self-hosted server: images stay on whichever machine/server the department installs it on; viewed via Orthanc web viewer, Stone Web viewer or OHIF plugins.
Diagnostic use: No regulatory statement found.
Anonymisation: Built-in anonymisation of instances, series, studies, patients; removes PS3.15 Table E.1-1 tags by default, private tags removed by default; does not address burned-in pixel text.
Spine-relevant features: Not a clinical viewer itself; viewing via plugins.
Still maintained: Yes: version 1.13.0 listed on download page (date not shown).

Note: Server software requiring IT administration and security configuration; not a stand-alone desktop viewer.

Developer page →Source checked

Checked 6 Nov 2026

MaciPad / iPhoneCleared for diagnosis (as stated)

OsiriX MD

Pixmeo (Switzerland)

Cost and licence: From US$69.99 per month (as stated on osirix-viewer.com); Proprietary, commercial

Details

Where images are processed: Desktop application, processed locally. Site links to 'OsiriX Study Sharing' and an 'OsiriX Cloud FAQ' (optional cloud features; not examined).
Diagnostic use: Stated as FDA-cleared Class II medical device for diagnostic imaging; footer states compliance with Directive 93/42/EEC as Class IIa, Notified Body DQS Medizinprodukte GmbH (0297). Body text says 'CE II labeled', which differs from the footer's Class IIa.
Anonymisation: Not mentioned on the home page checked.
Spine-relevant features: 2D/3D post-processing, 3D/4D navigation, plugin platform (no spine-specific tools stated on the page checked).
Still maintained: Yes: site states compatibility with macOS 27 and Intel/Apple Silicon; copyright 2026. No version number/date shown.

Note: macOS only; subscription cost; CE references cite the old Medical Device Directive 93/42/EEC rather than the EU MDR (status under MDR not verified); check whether optional cloud sharing is used.

Developer page →Source checked

Checked 6 Nov 2026

MacWindowsDiagnostic use not stated

Sante DICOM Viewer Pro / Lite / Mac

Santesoft LTD (Greece)

Cost and licence: Pro: US$280 single user, US$1,500 site licence; Lite (Windows) 'completely free'; Mac price not checked; Proprietary; Pro perpetual licence

Details

Where images are processed: Desktop application; contacts internet only to validate licence key and optionally check updates; patient data sent only via user-configured DICOM network, printers or disc producers.
Diagnostic use: Not stated on pages checked.
Anonymisation: Pro: built-in anonymiser (positioned as aiding GDPR compliance); batch anonymising can remove burned-in annotations and generate new UIDs.
Spine-relevant features: Pro: orthogonal MPR, 3D (isosurface, volume rendering, MIP), distance, angle, Cobb angle, area, volume measurements. Stitching not mentioned.
Still maintained: Yes (copyright 2026; version 10.x features referenced); no release date shown.

Note: Regulatory status not stated; Lite feature set narrower than Pro (anonymiser listed for Pro).

Developer page →Source checked

Checked 6 Nov 2026

MacWindowsLinuxWeb browserDiagnostic use not stated

Weasis

Open-source project led by Nicolas Roduit

Cost and licence: Free; Open source (EPL 2.0 and Apache 2.0)

Details

Where images are processed: Native desktop application, processed locally; can be launched from a hospital web portal to retrieve images.
Diagnostic use: No statement on medical device / diagnostic status on pages checked.
Anonymisation: Image export (current view) has an 'Anonymize' option that removes identifying information from the overlay; DICOM export can generate new UIDs but the tutorial does not describe header de-identification.
Spine-relevant features: MPR including oblique, volume rendering, calibrated distances, angles, ROI statistics. Cobb angle not mentioned.
Still maintained: Yes: v4.7.3 marked latest on GitHub, 25 Aug (year not shown; inferred 2026 from release sequence); the website now labels version 4.8 as current.

Note: No regulatory statement found - treat as not cleared for primary diagnosis unless a distributor states otherwise; DICOM export does not clearly de-identify headers.

Developer page →Source checked

Checked 6 Nov 2026

Removing patient details before teaching or sharing

Names and dates sit in the file header and can be burnt into the image itself. These tools remove the header details; burnt-in text often has to be blacked out by hand, and no tool guarantees every identifier is gone, so check the result.

MacWindows

DicomCleaner

David Clunie (PixelMed Publishing)

Cost and licence: Free; Free, open source (PixelMed toolkit)

Details

Where images are processed: Local desktop application.
Diagnostic use: Not applicable / no disclaimer on page.
Anonymisation: Removes or replaces identifying header fields with user control; optional date shifting; manual 'Blackout' of rectangular image regions for burned-in identifiers; no automatic detection of burned-in text described.
Spine-relevant features: Not applicable.
Still maintained: No date shown on usage page; no longer distributed as a Java Web Start application - download and install instead.

Note: Burned-in text must be blacked out manually; needs Java unless the Windows build with bundled Java is used.

Developer page →Source checked

Checked 6 Nov 2026

MacWindowsLinux

RSNA DICOM Anonymizer (V19)

RSNA (author listed as Algorhythm Software)

Cost and licence: Free (open source); RSNA-MIRC Public License (PyPI listing); the GitHub repository LICENSE file is Apache-2.0

Details

Where images are processed: Desktop install (also headless server mode); documentation does not explicitly state that data stays on the machine; optional AI models downloaded.
Diagnostic use: Not applicable / no disclaimer found.
Anonymisation: De-identification protocol; 'Remove Pixel PHI' / 'Clean burned-in text' workflow; OCR whitelists; optional AI face blur.
Spine-relevant features: Not applicable.
Still maintained: Yes: 19.0.7 released 10 Sept 2026 (PyPI); the GitHub README refers to 19.0.10 as the current stable release.

Note: Requires Python installation; local-only processing not explicitly stated.

Developer page →Source checked

Checked 6 Nov 2026

Never upload identifiable scans to free online viewers or AI chatbots

Free web viewers that ask you to upload files, and general AI chatbots, are not approved for patient data unless your hospital has a contract with the provider. Remove names, dates of birth and hospital numbers (including burned-in text) before sharing any image outside your organisation, and use the approved routes on Secure Messaging & Case Sharing.

How we compile this page

Each entry records only what the developer's own pages state, checked on the date shown. Inclusion is not an endorsement and NSpine has no commercial relationship with any developer. Where a page did not say something, we say so. This page is not legal or regulatory advice; we re-check it every quarter.

Left out or not yet confirmed:

Several free viewers (Horos, RadiAnt, Weasis and others) do not state their regulatory status; we show 'not stated' rather than guess.
OsiriX MD's CE statement refers to the older Medical Device Directive; its status under the MDR is not stated.
None of the viewers checked states that it can stitch long-leg or whole-spine images.
Cloud viewers that upload your images (for example PostDICOM) are not covered on this page.
Ginkgo CADx is not listed: it is no longer maintained (last release January 2019).