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Abstract— Picture Archiving and Communication System
(PACS) is commonly used in the hospital environment as the
tool to manage radiological images which has standardized on
the DICOM format. PACS usually consists of dedicated high
performance server computers to provide functionalities of
acquisition, storage, retrieval, editing (metadata), distribution
and presentation. As the personal computers become more
powerful, average desktop workstations can process large
amount of data with performance comparable to the high cost
dedicated systems. Recent desktop operating systems (OS) such
as Microsoft Windows Vista have built-in indexing and search
capability integrated with the graphic user interface (GUI) to
allow fast retrieval and customized presentation for digital
media and documents. Integrating DICOM image management
into desktop OS GUI can reduce the cost of software
acquisition, maintenance, and user training. We developed
DicomProp as a Windows plug-in to provide an easy to use
alternative for managing DICOM images on desktop
computers.
D
Managing DICOM Image Metadata with Desktop Operating
Systems Native User Interface
I. INTRODUCTION
IGITIAL Imaging and Communication in Medicine
(DICOM) protocol has been the standard for processing
and administration of medical image data. Picture Archiving
and Communication System (PACS) is commonly used in
the hospital environment as the tool to manage radiological
images which has standardized on the DICOM format.
PACS usually consists of dedicated high performance server
computers to provide functionalities of acquisition, storage,
retrieval, editing (image and metadata), distribution and
presentation. Due to the high cost of the PACS, they are
usually only installed in the large hospitals. Clinicians and
researchers who work outside the large hospital environment
often use a DICOM viewer application to work with images
on personal computers or workstations that are not connected
to PACS. As the personal computers become more powerful,
common desktop workstations can process large amount of
image data with performance comparable to the high cost
dedicated systems.
Recent desktop operating systems (OS) such as Microsoft
Windows Vista and Apple Mac OS X have built-in indexing
and search capability integrated with the graphic user
interface (GUI) to allow fast retrieval and customized
presentation for digital media and documentation. Integrating
DICOM image management into desktop OS GUI reduces
Manuscript received April 7, 2009.
Chia-Chi Teng is with the School of Technology, Brigham Young
University, Provo, UT 84604 USA (phone: 801-422-1297; fax: 801-422-
0490; e-mail: ccteng@byu.edu).
Chia-Chi Teng, Member, IEEE
the cost of software acquisition, maintenance, and user
training. It provides a low cost and effective alternative for
certain clinical and research environment where PACS is not
a practical or suitable solution.
Researchers often have to modify the metadata in DICOM
image files to de-identify the data for HIPPA compliance or
use the metadata to organize the images according the
subject, project or other attributes. Additional information
can also be added into the dictionary for annotation or other
purposes. While some DICOM viewer applications are
capable of modifying DICOM metadata, the process can be
cumbersome and often non-intuitive. We are developing the
software package DicomProp as a Windows plug-in to
simplify the process by allowing users to view and modify
DICOM image metadata through familiar operating system
graphic user interfaces.
Leveraging the native OS user interface and features
provides other benefits in addition to reducing the cost of
developing and managing separate applications. It improves
productivity through ease of use. Language localization is
also simplified through use of the operating system
infrastructures.
II. BACKGROUND
There are many DICOM viewer applications available
commercially, as freeware or as open source distribution.
Escott and Rubinstein conducted extensive surveys and
compared the functionality of many free viewers [1, 2].
While many of these viewers allow users to organize and edit
DICOM images, their user interfaces are not always
intuitive.
Some of the DICOM applications had attempted to
integrate DICOM viewer into the operating system GUI. For
example, MicroDicom [3] and DicomShell [4] both
implemented a Microsoft Windows shell extension which
allows Explorer to display DICOM images as thumbnail and
sort the files according to their metadata. QuickDicom’s
iiDicom Framework [5] implemented a Spotlight plug-in for
Apple Mac OS X which allows the user to search the
DICOM files via to the metadata values, but does not allow
editing.
Some DICOM viewer applications also provide the
functionality to edit the header information. For example,
Sante DICOM Viewer Pro [6] includes a DICOM Header
Editor which allows users to edit individual tag’s values.
This application can only edit one file at a time, and the

This property indicates the patient name.
...
Fig. 1. Property descriptions file for the DICOM property provider
Fig. 2. Customized details pane and info tip for DICOM image file type displaying selected header information
users need to run the viewer, then open the header editor in
order to change a tag.
Recent desktop operating systems such as Windows Vista
have provided extensibility such that DICOM image file’s
metadata can be exposed and integrated in the native GUI
and indexed by the desktop search engine. It is now feasible
for users to manage DICOM header information through
Windows Explorer instead of having to run another
application.
In Microsoft Windows Vista operating system, a property
provider [7] can parse a given file and returns its metadata,
both names and values, to the Explorer and search engine.
With the DICOM header information being indexed, user
can quickly search through and organize a large amount of
files using various DICOM specific attributes.
We are developing the DicomProp software package to
provide the following functionalities that are missing in the
DICOM tools currently available,
- Ability to modify the tags (metadata) in-place from
within the operating system GUI.
- Customizable UI allowing users or organization to
configure according to their needs.
- Ability to modify multiple files at the same time.
- Ability to search and organize DICOM image files
according to their metadata using the native desktop OS GUI
and search engine.
III. METHODS
Various mainstream operating systems have different
programming interfaces for their GUI Shell and desktop
search engine. Windows Vista allows programmers to
expose metadata of any given file type through its property
system as a shell extension. DicomProp currently includes a
property provider and a preview handler for the DICOM

Fig. 3. In-place editing for DICOM header information within the Windows Explorer
image file type (.dcm). The property provider extracts the
metadata of the selected DICOM image(s) and returns the
property values to both the Explorer and the search engine.
The programming interface of the property system is
documented in Microsoft Development Network (MSDN)
[7]. The DICOM property provider uses the CTN DICOM
library [8, 9] to parse and modify the dictionary in the image
files. The software source code is written in C/C++ using
Microsoft Visual Studio 2008 and Microsoft Windows SDK
version 6.
Windows Vista provides the extensibility for the property
provider to define the types of custom properties that can be
associated with the DICOM image files through a XML
property description schema. The format of the schema is
also described in MSDN; Figure 1 shows a subset of the
current prototype schema. We selected a small subset of the
DICOM dictionary to be returned from the property provider
to the operating system. This set of properties can be easily
expanded with addition property description and minimal
change to the code. Windows Vista also provides the
flexibility to customize the list of properties presented in
various views such as details pane and info tip, which only
requires a change to the registry without any modification to
the code. Unlike most of the DICOM viewers, this
implementation provides a solution that can be customized to
user or organizational preferences.
After the DICOM property provider is installed, the
properties of the selected DICOM image file are displayed in
the detail pane and info tip as shown in Figure 2. More
importantly, users can click on the properties in the detail
pane and modify their values. As shown in Figure 3, the
“Save” and “Cancel” buttons are presented as soon as
property values are modified; this example shows the user
changing the patient name, ID and birth date of the selected
file. Changes are only committed to the file when the user
clicks the “Save” button. This is done within the Windows
Explorer without having to run a viewer application.
Any of the DICOM properties can be added to the
Explorer’s detail view as a column through Windows’ GUI
and used to sort or group the file list. Figure 4 shows that a
column “Patient Name” is added to the folder view and the
files are grouped by the different patient names. Users can
selected multiple files or a group of files and modify their
property values at the same time, also as shown in Figure 4.
This feature, for example, can be particular useful for deidentification
where users can select a group of files and
remove their private information altogether.
The DicomProp property provider is also integrated with
the Windows native desktop search engine. As opposed to
being index as free text, DICOM image files are indexed
with their property name and value pairs. For example, a
DICOM file has patient name “John Smith” in the header;
the word “John Smith” is recognized as the “Patient Name”
property instead of just plain free text. This makes is
possible to search and organize DICOM files with specific
property values.
For lack of a better method, researchers or medical
workers who deal with large number of DICOM images on a
non-PACS workstation usually use directory or folder
structures to organize the images by patients, image date, or
other attributes. This is inefficient and it can be difficult to
search for a particular file or group of files. As the DICOM
files’ properties are indexed, users can not only search the
files from the search box, but also group and stack the files

Fig. 4. Modifying header information for multiple DICOM image files at the same time.
according to one or more properties. Virtual folders [12] can
also be used to quickly locate a list of files according to predefined
search criteria regardless of where they are in the
folder hierarchy.
IV. EVALUATION
DicomProp was developed using Microsoft Visual Studio
2008 and Windows SDK. We tested the prototype with a
variety of DICOM images acquired from several repositories
[10][11] including different image modalities, transfer
syntax, size and other features. At the time of the submission
of this manuscript, files with multi-frame compressed images
are not yet supported.
Performance of DicomProp was coarsely measured on an
Intel Core 2 Duo PC with 3GB memory and Microsoft
Windows Vista SP1 operating system. It takes approximately
7 seconds to commit DICOM header changes for 387 CT
images at a time through Explorer’s detail pane; each image
is 512x512 in dimension and 520KB in size. It takes the
same amount of time to commit changes of one property or
multiple properties.
V. CONCLUSION
DicomProp is developed as a simple light weight plug-in
for Microsoft Windows which integrates the DICOM image
management functionality with the native operating system
graphical user interface and desktop search engine. The
integrated user experience in Windows Explorer makes it
easy to modify the metadata of DICOM images as individual
files or as a group of files.
The software framework can support private tags of
DICOM header to enable custom applications. However,
adding or changing a private tag would require changing the
source code and rebuild the executable in the current
implementation. Future versions will allow users to define
private tags through a definition file without having to
modify the source code.
There are great cost and productivity benefits from
integrating DICOM image management with native desktop
operating systems. We merely used Microsoft Windows
platform as a starting point to prove the concept. We plan to
implement plug-ins for other desktop OS’s such as Linux and
Apple Max OS X. While initial results are promising, more
tests need to be done on a larger collection of DICOM
images. Future work also includes performance
improvements and more complete support for the DICOM
header dictionary.
REFERENCES
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