One of the most frustrating things that can happen inside a doctor’s private practice is trying to view a patient’s images from a recent scan in vain. The computer is brand new, there is a high-speed internet line available, and the online DICOM viewer that the doctor recently downloaded should open the images—except it doesn’t!

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But not only doctors in their offices, hospitals have to deal with the same issue with radiologists and physicians complaining about not being able to do their job when they run into technical difficulties while attempting to view clinical images. Is it their fault? Is it the viewer? Is it the 15-year-old computer that’s responsible? In any case, when this happens, doctors are unable to proceed rapidly with the diagnosis and treatment of patients. Therefore, it is vital to choose the best DICOM viewer that will perform smoothly day in and day out and will never let you down!

RadiAnt DICOM Viewer enables users to make use of the array of multi-touch gestures: Touch the image with one finger and move it to browse through images of the displayed series. To zoom in or out, touch two points on the image, and then move your fingers away from or toward each other. PostDICOM is one of the best DICOM viewers that offers almost all of the above.

This video shows how to install RadiAnt DICOM Viewer on macOS Mojave 10.14.3 using Wine. Check our website for the latest updates to this tutorial: https://w. RadiAnt DICOM Viewer enables users to make use of the array of multi-touch gestures: Touch the image with one finger and move it to browse through images of the displayed series. To zoom in or out, touch two points on the image, and then move your fingers away from or toward each other. TeamViewer Host. TeamViewer Host is used for 24/7 access to remote computers, which makes it an ideal solution for uses such as remote monitoring, server maintenance, or connecting to a PC or Mac in the office or at home. Install TeamViewer Host on an unlimited number of computers and devices. As a licensed user, you have access to them all!

Which operating system should I use?

Well, here start the real issues because there are enthusiasts who cheer for both Windows and Mac OS but they usually fight over minor things. Most of the “switchers” from MS to Mac and vice versa agree that personal preference is what this is all about. Regardless and when it comes to choosing a DICOM viewer, it’s always safer, more flexible and more preferable to go with a DICOM viewer for Mac which is also compatible with MS Windows and Linux rather than getting a DICOM viewer that will run only on a specific operating system. This will save you from a lot of frustration in the long term.

What do I have to ensure regarding the operating system?

First, you need to determine which DICOM viewer is compatible with your operating system. Not every DICOM viewer works with MS Windows, Mac and Linux at the same time. There is a plethora of DICOM viewers out there but most of them work with either Windows or Mac but not both. So, a healthcare professional needs to decide accordingly.

Second, you will need to make sure that the viewer will autorun once installed. Most of the DICOM viewers out there do have an autorun integrated. However, there are still several choices available that require the installation of specific software first. This procedure makes the system slow and the performance is suboptimal which eventually costs time and money.

Which functions do DICOM viewers generally perform?

DICOM viewers available on the market offer the following functions:

• Image viewing

• Image exporting (teaching, presentations)

• Storage

• Sharing images with other healthcare professionals

• Mini-PACS servers

• Research

Needless to say, the final choice of a DICOM viewer depends on the features that a healthcare professional deems most suitable for their needs. It also depends on the workplace environment. A private practice needs more speed and versatility whereas a hospital group will focus on 3D reconstruction, image editing and manipulation and other advanced tools. A very important feature is a cloud-based PACS system which has come as a breakthrough in the industry. Instead of simply transmitting the images to the workstation, the network of the images is massively broadened and from there, the possibilities are endless. Since any HTML5-compatible device can have access to the cloud, professionals like doctors, nurses, physicians, physiotherapists, and surgeons can share patients’ images all around the globe in an instant! It has become imperative for new DICOM viewers to be integrated with cloud-based PACS.

What exactly is cloud-based PACS? Should I get it?

PACS (Picture Archiving and Communication System) works by using hardware and software components to acquire images from medical imaging devices—such as CT, MRI, ultrasound, or radiography devices, then converts the files into the DICOM (Digital Imaging and Communications in Medicine) format and moves them to workstations where they can be accessed and reviewed.

To sum up, PACS is the actual software which enables us to exchange, store and share the images while DICOM is the standard file format that makes this possible. There are two forms of PACS: local PACS and cloud-based PACS. Cloud-based PACS is a market-changer because it

• Offers more storage

• Is safer

• Is cheaper in terms of both upfront and maintenance costs

• Enhances collaboration across the globe

In order to fully understand the breakthrough that a cloud-based PACS stands for, we need to imagine working with and without it. With a local PACS, the only professionals able to view the images are the ones logged in the same Local Area Network. That limits the access to vital information about the patient’s health. That also makes the system heavier and slower with maintenance problems constantly arising. On the other hand, with the use of a cloud-based PACS and a fast free DICOM viewer, literally anyone with an HTML5-compatible device can access the system from anywhere on Earth! The advantages of such a system are enormous and the effects on improving health outcomes for patients cannot be overlooked.

Should I go for a free or paid version of an online DICOM viewer for Mac?

There are many online versions of DICOM viewers on the web. Some of them are free and some aren’t but most of them have a trial version of 30 or 45 days. After that, a paid subscription is always the case where more premium tools and features are available. However, if someone searches hard enough, they will come up with free Dicom solutions that provide all the “goodies’’ and at the same time stay free regardless of how long you use them. So, pay for the DICOM viewer that you prefer only if it’s absolutely necessary. Please do anything in your power to stay away from scams, hacks and unnecessary software downloads.

Which are some of the best DICOM image viewers for Mac?

• PostDICOM: One of the best free DICOM viewers for Mac out there. It is also compatible with Windows and Linux and provides advanced tools and features. Image manipulation, 3D reconstruction, MIP, MRP and image fusion are all available in the free version. There is a paid subscription for those interested but the free version comes with 50 GB of free cloud-based storage space.

• Horos: This is actually a free version of Osirix MD which is probably the best DICOM viewer for Mac. It provides the doctor with many options such as image reconstruction, volume rendering, making measurements and image uploading to Radiopedia. Horos is free but if you want cloud-based storage, you have to pay because it doesn’t come with an integrated PACS system.

• 3DimViewer: Very light, efficient and practical. This software will help the beginner get the grasp of things while learning the basics of DICOM viewer usage. It will run on any operating system (Mac included) and will offer multiplanar views but no image editing, sharing and exporting.

• Miele LXIV: This is a free DICOM viewer for Mac. It can show MRP, MIP and allows 4D viewing of cardiac CTs. Another advantage is that it is integrated with a cloud-based PACS so exporting, sharing and storing of the images is very easy.

• Gingko CADx: Very convenient because it is compatible with Windows, Mac and Linux operating systems. It can support PACS but provides no advanced tools in the free version. All these features are available in the paid version.

Are there any other specs that I should know about?

Yes, there are:

• Favorites list: You may want a free online DICOM viewer with the option of a list of favorites. For instance, if the healthcare professional is a spine surgeon, they might find it helpful for a specific image to pop-up on their screen when the software runs. This image can be the sagittal view of the L4-L5 disc space or all the axial views of the cervical spine.

• Brightness setting: Some viewers offer the ability to automatically set the brightness of the screen at an appropriate level according to the hour of the day and how dark or bright the workstation actually is at that moment. This feature can be preset as well by the operator should the working environment remain the same at all times.

• Scroll wheel: One feature that can be annoying when using an online DICOM image viewer is the function of the scroll wheel. Not all software makers agree on what scrolling up or down should mean in terms of what the doctor would like to do and the results are catastrophic. Sometimes scrolling up/down means zoom in/out. Sometimes it equals to moving to the next/previous image. Sometimes it means “change the sequence.” And these apply on viewing CT and MRI scans. When someone wants to view X-rays of a patient using a DICOM viewer, they might consume more time than if they were printed in the first place. Left clicks and right clicks are involved but only immediately after you select which image you want to view. Great care must be taken if you want to zoom in. Not to mention the patience needed to view an image on a smartphone or a tablet. So, keep in mind that the exact specs matter and that the viewer’s “gameplay” correlates with your workflow.

• A useful red line: Most healthcare professionals agree that the addition of a small window in the bottom left or right corner with a red line in the middle as an indication of where exactly the “cut” of the examination area actually is, is mandatory. Many images even in the eyes of the most experienced healthcare professionals look the same after many hours of work and the presence of a helping box ensures that there will be no mistakes. It also guides the doctor exactly to the spot where the problem is and saves time and energy. This red line also helps with the cross-examination of doctors with different specialties and with reference scans that took place in the past as well. If you download an online DICOM viewer for Mac with no such tool it won’t mean the end of the world but you have every reason to get it.

• Anonymity: This is another very important feature. Ethics committees have already established firm guidelines to protect the patients/citizens from leakage of personal data. On one hand, it is essential for the patient-doctor cooperation that the latter has access to all the previous tests and scans that the patient underwent. On the other hand, all of the patient’s personal information is written on them and in terms of anonymity, this access should be limited. That is exactly why the DICOM viewer chosen must have the option to fully erase the patient’s data or simply hide them using a single switch. It is up to the doctor at this point to make good use of their patient’s personal information and do not use it for research, making presentations, or oral speeches without the patient’s written consent. In any case, a DICOM viewer for Mac should provide with the option of full anonymity.

Which is the best DICOM viewer for Mac for me?

To summarize, when someone looks for the best and most reliable DICOM viewer for Mac, they look for practically everything: versatility, flexibility, cutting-edge technology and low cost. We believe that PostDICOM offers the best solution overall because it runs not only on Mac OS but on Windows and Linux as well. It comes with all the necessary features and premium tools such as MRP, MIP, 3D reconstruction and rendering and offers sharing, exporting, exchanging and storing of the images. On top of that, it is integrated with a cloud-based PACS which expands the potential of the system tremendously. No more worrying about speed, slow workflow, technical issues or difficult-to-use software. PostDICOM comes with 50 GB free storage space to begin with and free technical support. If these aren’t enough for the advanced user, there are pro editions of PostDICOM where all the features are enhanced ensuring maximum performance. PostDICOM can satisfy even the most demanding user as it offers everything there is when it comes to image viewing. And you can do that quickly, on-demand, from ANY device and in style!

The best free software solutions for DICOM images

Sometimes it's useful to be able to view and manipulate medical images such as X-rays, CT or MRI scans on your own PC, laptop or tablet. This is particularly important when preparing teaching files or practising for your radiology exams. Finding a good free DICOM viewer can be tricky, especially as there are so many options out there. We have tested may different applications (so you don't have to) and the following are our best picks. We grouped them according to the operating system used because unfortunately there aren't any free viewers that run on both!

A popular software for radiologists working in the UK is currently a programme called 'Horos'. This is a free open source version of the software used by the Royal College of Radiologists for the viva part of the Final FRCR 2B exam, so obviously it makes sense to use it for teaching as well. This programme is only available on Apple computers, hence why so many radiologists own MacBooks.

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There is a paid version of Horos called 'OsiriX MD', which is produced by Pixmeo, however it is expensive so not ideal for basic teaching purposes, although has great functionality. Pixemo also produce a free demo version called 'OsiriX Lite', however there are major limitations placed on this including pop-ups asking you to upgrade to the paid version, performance restrictions, image viewing restrictions and inability to edit the meta-data attached to DICOM images - for example you can't easily re-order series within a study, which may be important if you are preparing cases for teaching or examinations. It is for these reasons that we do not list OsiriX Lite in our recommendations.

• The OsiriX UK user group are a group of Radiologists in the UK who are keen on digital radiology education and use OsiriX/Horos for teaching. The aim is to achieve a nationally agreed consensus on how cases are collected, organised and used for teaching and examination and thereby achieve a collective common ground/platform/standard for radiology education across the country. The resources on this site are amazing so we recommend you visit it now!

Software for Apple MacOS

Radiology Cafe's top pick:

Main features

• Intuitive user interface and customisable toolbars
• 64-bit
• Advanced manipulation and measurement tools
• Multi-planar reconstruction (MPR) with thick slab (Mean, MIP, Volume Rendering)
• 3D MIP, 3D Volume rendering, 3D surface rendering
• Image fusion for PET-CT & SPECT-CT
• Reads and displays all DICOM files
• DICOM Editing
• OsiriX migration assistant
• Separate iOS app to view DICOM on mobile devices (requires iOS 13.0 or later)

System requirements

• OS: MacOS 10.11 or later

Horos should run on any Mac brought within the last 3 years.

Why we like it

We really like Horos as it is a free open source version of the same software as that used by The Royal College of Radiologists for the viva part of the final FRCR (Part B) exam. Becoming familiar with Horos will help radiology trainees when preparing for this exam. Horos is easy to use and as a full 64-bit medical image viewer for Mac there is a huge amount of functionality contained within. It is updated regularly. We believe Horos is the best free DICOM viewer for Apple MacOS.

Interestingly, Horos is named after the Egyptian god Horus, son of Osiris and Isis. Horos is a based on OsiriX (a similar paid-for medical viewer), named after Osiris. The developers obviously appreciate Egyptian and greek mythology!

Visit the Horos website to download the Horos DICOM viewer!

• There is a useful Mac plug-in for Horos that allows you to quickly upload selected studies / images to Radiopaedia, a free educational radiology resource with one of the web's largest collections of radiology cases and reference articles.
• User guide and installation guide:
  https://radiopaedia.org/blog/radiopaedia-plugin-for-horos-osirix

Software for Microsoft Windows

Radiology Cafe's top pick:

Main features

• Simple and intuitive interface with full-screen mode
• Standard manipulation and measurement tools
• Browse several series concurrently in multiple windows with automatic synchronization between series and cross reference lines in series with different image planes
• Display of dynamic sequences/series (CINE)
• Multiplanar Reconstruction (MPR)
• Fusion of series with different modalities (e.g. PET-CT) or different protocols (e.g. MRI T1/T2–DWI)
• Huge range of DICOM file types supported and support for DICOM overlays
• Export DICOM files to JPEG, BMP and WMV.
• Copy and paste directly into Word or PowerPoint documents
• Read DICOM studies from CD/DVD/BluRay disks and local or network folders
• Asynchronous reading (browse images while they are being opened)
• Multi-core and multi-processor support, and advanced memory management system which facilitates concurrent opening of studies with thousands of images
• Universal installer (32 and 64-bit)
• Multilingual interface (>20 languages)
• Multi-touch support
  more feature details...

System requirements

• OS: Windows 10/8.1/8/7/Vista/XP (SP3)
• Processor: Intel or AMD 1GHz or faster (multicore Intel processor recommended)
• Memory: 512MB of RAM (2GB recommended)
• Hard Disk Space: 9MB of available hard-disk space for installation; additional free space required for image caching
• Screen Resolution: 1024x768 minimum

Why we like it

We really like RadiAnt as it is free, simple, easy to use and very fast. Watch this YouTube demonstration video to see RadiAnt in action. It is downloaded as a single compact application with an installer size of approximately 5MB. The application can even run directly from a USB stick! This basic DICOM viever does all the things you would expect and is perfect for revision purposes for radiology trainees.

Visit the RadiAnt website to download the RadiAnt DICOM viewer!

Radiology Cafe's one to watch:

Main features

• Designed mainly for CT and MR DICOM modalities
• 3D reconstruction and volume rendering
• Multi-planar and oblique slicing
• Easily anonymize and de-identify patient scans
• Fast surface extraction and export to STL and PLY formats
• Load DICOM data directly from PACS, CD/DVD, USB or local computer
• Patient search to locate patient data on your PACS
• Loads common non-DICOM file formats: NifTi (.nii), Visualization Toolkit (.vtk), and ANALYZE (.hdr)
• Window/level (brightness and contrast) presets
• Screen capture
• Axis-aligned cropping with context
• Side-by-side comparative assessment
  more feature details...

System requirements

• OS: Windows 10/8.1
• Processor: Intel i3 or AMD Ryzen 3 (64-bit CPU for data sizes over 100MB)
• Memory: 8+ GB of RAM
• Hard Disk Space: 1GB of available hard-disk space for installation; additional free space required for image caching
• Screen Resolution: 1920x1080 or better

Why we like it

We like Pro Surgical 3D as it is fast and easy to use. Although it is designed for surgeons, it's easy to view patient scans quickly. It works well with studies on CD/DVDs, USB sticks and local DICOM files.

Visit the Pro Surgical 3D website to download the Pro Surgical 3D DICOM viewer!

Online Software

Radiology Cafe's top pick:

Main features

• Unlimited cloud storage space to store medical images
• Multi-platform (Windows, MacOS, Linux, IOS, and Android) Support
• Upload, store and view DICOM files
• Fast Cloud DICOM imaging loading
• Automatic synchronization of compatible series with showing cross-reference lines
• Standard measurement tools
• Multiplanar Reconstruction (MPR)
• View DICOM metadata
• Share, tag and comment on cases with other professionals
• Enter custom descriptions to cases
• WebGL browser rendering
• PACS integration using the Collective Minds® Proxy
• One click case upload using the Collective Minds® Proxy
  more feature details...

System requirements

• The following operating systems and internet browsers are supported:
  • Windows: Google Chrome, Mozilla Firefox
  • Mac OS: Apple Safari, Google Chrome
  • Linux: Google Chrome
  • iOS: Apple Safari, Google Chrome
  • Android: Google Chrome

Why we like it

We really like Collective Minds Radiology as it is a bit different to other sites. It's a radiology collaboration service and centered around sharing cases with other professionals for expertise, advice or teaching. It is free with unlimited storage, easy to use and fast. As it is cloud based, you can access it on pretty much any device. The service is restricted to medical professionals and sharing can be done to specific groups e.g. your hospital community. The ability for users to comment and tag images is particularly unique and great for learning and teaching.

Visit the Collective Minds website to use the Collective Minds Radiology viewer!

So there you have it!

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Radiology Cafe's 'top pick' and 'one to watch' free DICOM viewers for Microsoft Windows, Apple MacOS and online. Please send us your suggestions for other great free DICOM viewers!