Which Standards Does DICOM® Use?

The DICOM standard utilizes several other well-established standards:

  • DICOM addresses multiple levels of ISO‘s OSI network model. It uses both TCP/IP and HTTP as transport mechanisms, while JPEG and MPEG are recognized as content types. It also has its own standard MIME type.
  • DICOM embraces broadly based network protocols for infrastructure management and security (e.g., LDAP, DHCP, NTP, SAML, etc.). DICOM profiles the use of those standards in the biomedical imaging environment (see Part 15).
  • SNOMED CT is the preferred coding system within DICOM for anatomy, clinical findings, procedures, pharmaceutical/biologic products (including contrast agents), and other clinical terms.
  • LOINC is another external vocabulary referenced by DICOM; LOINC terms are extensively used in value sets and structured report templates.
  • BI-RADS terminology and reporting templates are used in DICOM Structured Reports for breast imaging.


Which Standards Use DICOM®?

The DICOM standard is incorporated in a variety of imaging related IHE integration profiles, and in imaging related HL7 FHIR resources. Both ISO12052:2017 and CEN 12052 are normative references to the DICOM standard.


HOW Does DICOM® Relate To Other SDOs?

The DICOM organization has working relationships with several other standards development organizations (SDOs):

  • IHE – DICOM has a strong relationship with IHE, the Integrating the Healthcare Enterprise initiative, where profiles of standards are defined as solutions for healthcare workflow and enterprise integration challenges.
  • HL7 – A joint DICOM/HL7 working group has existed for many years to contribute to the development of the HL7 standards, propose extensions to the DICOM and HL7 standards where appropriate and develop information linkages between the DICOM and HL7 standards.
  • SNOMED – DICOM and SNOMED have a license agreement that permits the use a subset of SNOMED-CT free for use, both for publication in DICOM as well as by implementers and users of DICOM-compliant products globally, without restriction to SNOMED member countries.
  • ISO – The DICOM Standards Committee has an active type A liaison to ISO’s TC 215. This technical committee has decided not to create an imaging working group, but to rely on DICOM for bio-medical imaging standards.
  • IEC – DICOM has a type B liaison with IEC’s SC 62B (Diagnostic imaging equipment) and SC 62C (Equipment for radiotherapy, nuclear medicine and radiation dosimetry).
  • JIRA – The Japan Medical Imaging and Radiological Systems Industries Association is a long-standing member of the DICOM Standards Committee.
  • JIC – DICOM is a member of the Joint Initiative Council for Global Health Informatics Standardization, formed to enable common, timely health informatics standards by addressing and resolving issues of gaps, overlaps, and counterproductive standardization efforts.

HL7 is a registered trademark of Health Level Seven International. SNOMED and SNOMED CT are registered trademarks of the International Health Terminology Standards Development Organisation. ISO is a registered trademark of the International Organization for Standardization. LOINC is a registered trademark of Regenstrief Institute, Inc.