DICOM and DICOM Routing: A Practitioner's Guide to the Standard, the Workflow, and the Operations

The DICOM book practitioners actually need. Medical imaging runs on DICOM. Every CT, every MRI, every X-ray, every ultrasound — encoded, transmitted, archived, and retrieved using a standard that's older than the World Wide Web and just as fundamental to its domain. Yet most people responsible for DICOM in working hospitals learned it the hard way: piecemeal, from vendor docs and on-the-job firefighting. The standard itself runs to thousands of pages of dense specification. Existing books are either narrowly academic or focused on radiologists, leaving a gap exactly where it hurts most. This book fills that gap. DICOM and DICOM Routing is a structured, opinionated, practitioner-focused guide written for the IT professionals, developers, and clinical informaticists who have to make medical imaging actually work. Twelve chapters take you from "what is DICOM" to "how do I run a router in production" — with every concept grounded in a recurring example (a fictional patient named Maria) that ties abstract ideas to concrete clinical reality. What you'll learn The DICOM file format — tags, value representations, transfer syntaxes, what's actually in those bytes The DICOM network protocol — Application Entities, associations, the four DIMSE-C verbs, the C-MOVE three-way handoff that confuses everyone the first time The information hierarchy — Patient → Study → Series → Instance, with the identity and UID strategies that work across institutions Clinical workflow integration — where DICOM meets HL7, RIS, EHR, and the full lifecycle of an imaging exam DICOM routing in depth — how routers work internally, designing rules that hold up, the four production patterns you'll meet again and again Troubleshooting — five named failure modes, a structured debugging method, the diagnostic toolkit that turns 3 AM pages into 30-minute fixes Production operations — TLS, authentication, audit logging, monitoring, alerting, change management, and a ten-item production-readiness checklist Beyond classical DICOM — DICOMweb, IHE profiles, and where the standard is going next What's included 360 pages covering the standard, the workflow, routing, troubleshooting, and operations 96 worked exercises with complete answers — eight per chapter, building from recall to design Quick reference cards for tags, VRs, transfer syntaxes, services, and error codes 20 production-ready routing recipes covering AI integration, teleradiology, multi-site, DR, and de-identification A guided conformance statement walkthrough — the procurement skill that pays back every integration A complete laptop lab setup with Orthanc and dcm4che, with seven progressive exercises Comprehensive glossary of 85 DICOM terms with chapter cross-references Who this book is for If you're a mid-career IT professional newly responsible for a hospital's imaging environment, a developer building software that integrates with healthcare systems, a PACS administrator who wants to understand the standard from first principles rather than by accumulation, a clinical informaticist working alongside imaging teams, or a vendor engineer building DICOM-aware products — this book is for you. The book assumes you're comfortable with networks (TCP, ports, basic HTTP), with software (you can read pseudocode, you've used a command line), and with healthcare IT in general (you've heard of HL7, you know what an EHR is). It does not assume any prior DICOM experience. Start reading. By the end, you'll know DICOM the way the standard's designers intended — and the way working environments actually need.