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What is PACS?
PACS in medicine stands for Picture Archiving and Communication System (PACS) a medical imaging technology which provides economical storage and convenient access to images from multiple modalities (source machine types).
What are PACS components?
PACS components consist of: a digital electronic archive for storing, indexing, and retrieving the images or reports, a workstation to query, process the image like web-based viewers, mobile/ tablet or desktop clients (desktop workstations), secure network for data transmission and of-course the imaging machines.
According to Zion Market Research study, that published in (Oct. 31, 2018), The global market for PACS and RIS (Radiology Information Systems) was valued USD 2.6 billion in 2017, and it's expected to reach USD 4.3 billion by 2024(ref).
Open-source projects has a very slight share of PACS/ RIS growing market, but it's growing steadily.
as we were fortunate to witness enterprise-grade open-source PACS/ DICOM solution which comes with professional enterprise services from companies competing with closed-source proprietary solutions providers.
Why should you use open source?
- [-] Cost efficient
- [-] Powered by open-source technologies
- [-] Community Supported alternatives
- [-] Community-powered development
- [-] Flexible integration model
- [-] Developer-friendly
1- Orthanc: Developer-friendly DICOM server
Orthanc is an open-source, modular, lightweight DICOM server project originated from Belgium by Sébastien Jodogne. It comes with rich API and several plugins which supports different database and DICOM viewers.
Orthanc is the favorite open source DICOM server for many healthcare facilities, hospitals, and research centers around the world, It's used in France, Pakistan, 2 hospitals in Malaysia, Sweden, Israel, and Netherlands.
Orthanc Pro is a commercial service for Orthanc, It includes support, custom development, integration, maintenance, and training.
2-Dicoogle: Open source modular PACS system
Dicoogle is an enterprise-grade open source PACS system, It has a modular structure that packed with developer-friendly SDK to allow developers to build medical imaging server-ready applications.
Dicoogle has powerful archiving, indexing and query options with highly scaled infrastructure that been tested with +25 million indexed DICOM objects.
Dicoogle comes with a set of API to build cloud-based DICOM applications. Dicoogle's documentation includes detailed manual about Dicoogle installation, configuration, and setup, with a comprehensive guide for building plugins for Dicoogle and web/ cloud applications.
Dicoogle's developers have released under GPLv3.0 License.
3- OHIF: Framework PACS-Ready DICOM Viewers
OHIF DICOM Viewers is providing a complete PACS interface for experienced developers, currently it's built on NodeJS/ React.
4- JVSdicom Server: Windows DICOM-ready PACS Server
JVSDicom is an enterprise-grade open source DICOM-compliant PACS server. It supports multiple simultaneous connections. JVSDicom is built with C++ and supports 32-bit and 64-bit architecture, It works with many Windows versions including the old versions like Windows 2000, Windows XP and Windows Vista, as it works well in Windows 8 and Windows 10 with powerful support for Windows Server editions. JVSdicom uses flat filesystem based storage and comes with DICOM-JPEG2000 support.
License: JVSdicom is published under GPL. It was last updated in 2008.
5- EasyPACS - DICOM Server: MySQL powered PACS server
EasyPACS is a powerful PACS DICOM-ready server, The developer built it with Java which makes it cross-platform and lightweight. EasyPACS uses dcm4che API and MySQL as Database backend to store and populate data.
EasyPACS's developer uses a set of powerful framework and specifications to provide an efficient and fast end-product, which are supported by the majority of Java developers, and that makes it easier to extend it with more features with the right developer.
6- NeurDICOM: Headless RESTful PACS server with plugins support
NeurDICOM is an open source headless/ RESTful PACS server solution for developers, It was built to be easily integrated with machine learning and neural networks software to empower diagnosis with artificial intelligence.
NeurDICOM has a modular architecture, and clear well-documented API for developers, so it's easy to build apps on it and integrated it with an existing application, framework, or workstation. Plugins are developed by Python, but the developer may write his plugin with C or C++ as well.
Reactmed, the developer of NeurDICOM has released several DICOM/ PACS related open-source project written with different programming languages like Go, Java, and C++, With different fork for NeurDICOM itself in Go & Java as Headless DICOM Server.
7- PacsOne Server
PacsOne Server is a free open source DICOM 3.0 compliant PACS server, Its the 2nd one on this list that uses MySQL as Database backend, It has 2 editions the Basic edition a free open source version which comes with limited support and the Premium Edition, that comes with premium support service but with low cost comparing to the expensive commercial alternatives.
Note about the PacsOne Server free version:
PacsOne Server Basic Edition is available for free, may be used to support both open and proprietary applications, and may be freely modified or distributed.
However, any changes including addition, modification or deletion to the original PacsOne Server Basic Edition package shall be made available to other users by sending a copy of your changes to us.
PacsOne Server: Premium edition, has many advanced features than the free edition which includes: HL7 support, New OS versions support for Linux, Mac OSX and Windows, HIPAA complaint features, with a sophisticated user, user-groups, and permissions management.
8- PACSsoft PACS: Cloud/ Web-based PACS Server
PACSsoft PACS is a complete web/ cloud-based PACS/ DICOM solution, based on 14 years of engineers who build a very successful DICOM server with DICOM viewer. The core server is a lightweight and fast DICOM server, easy to set up and installs on Windows operating systems, backed with web-based administration dashboard, and HTML5 web-based DICOM viewer that works well with web browsers.
The project has been released as an open-source alongside DICOMSharp.
9- Dcm4Che: Java-based DICOM toolkit for developers
It would be unfair to finish this article without the cornerstone of many open-source PACS/ DICOM server projects, Dcm4Che is a powerful open source DICOM library & tools built by Java.
It has been used all over the world by many open-source and commercial projects. The dcm4che project includes a set of enterprise services based on the open-source library, Dcm4Chee. While Dcm4Che is aiming for developers, Dcm4Chee services contain DICOM server, HL7 server, Web-based interface.
10- J-PACS: Java DICOM server
J-PACS is Java-based DICOM server, it has its code published for developers but without description or enough details for installation, implementation, or usage. It comes out the last year, so lets hope the developer will add some documentation about it later.
11- XNAT-DICOM Gateway
XNAT-DICOM Gateway is a part of DICOM toolkits provided by XNAT as an open-source library to create PACS server. It works smoothly on Windows, Linux (Ubuntu, Read hat Linux, Debian), and macOS.