DICOM / PACS viewing software

The best free software solutions for DICOM images


Sometimes it is 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!

 


 

What is DICOM viewing software

DICOM stands for 'Digital Imaging and Communications in Medicine'.  It is the standard for handling, storing, printing, and transmitting information in medical imaging.  DICOM viewing software allows radiology trainees and consultants to view and manipulate medical images (such as radiographs or MRI scans) on their own PC, laptop or tablet.  In the hospital environment, this forms part of the picture archiving and communication system (PACS), which doctors will be familiar with!


A popular software for radiologists working in the UK is currently a programme called OsiriX.  This is this software used by the Royal College of Radiologists for the First FRCR Anatomy and Final FRCR 2B exams (although this is likely to change in the next couple of years) 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.  Unfortunately there are a few major problems with OsiriX.  The first problem with OsiriX is that it costs £756!

"Whoa, Hold on!", I hear you say.  I thought this page was about free DICOM viewing software!  Where did the £756 come from?!  Well £756 is the cost of the full version of OsiriX (called 'OsiriX MD'), however there is also a free version called 'OsiriX Lite'.  It's the free version that the vast majority of radiologists use, however recently there have been major limitations placed on this programme to encourage users to pay for the full version.  These limitations include adding 'NOT FOR MEDICAL USE' in red letters to every image, performance restrictions (OsiriX Lite is only 32-bit, not 64-bit) and image viewing restrictions.  More frustratingly, in OsiriX Lite you cannot edit some of the meta-data attached to DICOM images - for example it is now difficult to re-order series within a study, which may be important if you are preparing teaching cases or examinations.

It is for these reasons, and more, that we have decided to give our recommendations to help you decide which programme is best for you!

 

 OsiriX-UK user Group

  • 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!
  • http://www.osirix-ukusergroup.org  

 

Software for Apple MacOS

 

Radiology Cafe's top pick:


Horos DICOM viewer screenshots

Horos DICOM viewer screenshots

 

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
  • Telephone and E-mail Support Available

    more feature details...

 

Horos DICOM viewer screenshots

Horos DICOM viewer screenshots

 

System requirements

  • OS:  MacOS X 10.8 or higher

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

 

Horos logoWhy 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 first FRCR anatomy exam and final FRCR (Part B) exams.  Becoming familiar with Horos will help radiology trainees when preparing for these examinations. Horos is easy to use and there is a huge amount of functionality contained within.  It is based upon OsiriX, however it doesn't have the software restrictions that 'Osirix Lite' has meaning that it is a fully functional 64-bit medical image viewer for MacOS X.  It was released in 2015 and 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, named after Osiris.  The developers obviously appreciate Egyptian and greek mythology!

Visit the Horos website to download the Horos DICOM viewer!

 

 Radiopaedia plugin for Horos


 

Radiology Cafe's one to watch:


OsiriX Lite DICOM viewer screenshots

OsiriX Lite DICOM viewer screenshots

 

Main features

  • Intuitive user interface and customizable toolbars
  • Advanced manipulation and measurement tools including image stiching
  • 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 and many other file types
  • Limitation: Unable to easily edit DICOM images
  • Limitation: Only 32-bit with 4-GB image upload limit
  • Limitation: Will not open series with >500 images
  • Limitation: "NOT FOR MEDICAL USAGE" tag displayed on all images

    more feature details...

 

OsiriX Lite DICOM viewer screenshots

OsiriX Lite DICOM viewer screenshots

 

System requirements

  • OS:  MacOS X 10.8 or higher

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

 

OsiriX Lite logoWhy we like it

We like Osirix Lite as it is a free version of the same software as that used by The Royal College of Radiologists for the first FRCR anatomy exam and final FRCR (Part B) exams.  Osirix is easy to use and there is a large amount of functionality contained within as a result of over 10 years of research and development.  The main disadvantages of OsiriX Lite over Horos is that the software has been dumbed-down (unless you fork out £704 for the full version of OsiriX MD).  OsiriX Lite is only 32-bit (not 64-bit) meaning that it doesnt take full advantage of modern computing power.  There is a 4GB upload limit and it will not display series of 500+ images.  More frustratingly every image has "NOT FOR MEDICAL USAGE" displayed and you are constantly nagged with adverts to upgrade to OsiriX MD.  Even so, we believe OsiriX Lite is a good free DICOM viewer for Apple MacOS and you will not be disappointed.

Visit the OsiriX Lite website to download the OsiriX Lite DICOM viewer!


 

Software for Microsoft Windows

 

Radiology Cafe's top pick:


RadiAnt DICOM viewer screenshots

RadiAnt DICOM viewer screenshots

 

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 for Windows 8

    more feature details...

 

RadiAnt DICOM viewer screenshots

RadiAnt DICOM viewer screenshots

 

System requirements

  • OS:  Windows 10/8/7/Vista/XP (SP2 or SP3)
  • Processor:  Intel or AMD 1GHz or faster (multicore Intel processor recommended)
  • Memory:  512MB of RAM (2GB recommended)
  • Hard Disk Space:  5MB of available hard-disk space for installation; additional free space required for image caching
  • Screen Resolution:  800x600 (at least 1024x768 recommended)

 

RadiAnt mascotWhy 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 just over 2MB. 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:


Navegatium DICOM viewer screenshots

Navegatium DICOM viewer screenshots

 

Main features

  • Simple intuitive touch interface
  • Basic manipulation, annotation and measurement tools
  • Multiplanar (MPR), volume (3D) and X-ray reconstructions
  • MIP, simulated x-ray reconstruction and colour palettes
  • Customize the layout: 3 views (axial, sagittal, coronal), 4 views (3 + volume) or full-screen display
  • DICOM Tags anonymization and DICOM Tags editor
  • Import scans directly from local media, PACS or the cloud
  • Create and print reports
  • Easy to use
  • Limitation: A little too basic with minimal functionality

    more feature details...

 

Navegatium DICOM viewer screenshots

Navegatium DICOM viewer screenshots

 

System requirements

  • OS:  Windows 10/8.1
  • Processor:  x64
  • Hard Disk Space:  60MB (approx)

 

Navegatium logoWhy we like it

We really like Navegatium as it is free, simple and works very well with touchscreen computers and tablets. It is downloaded as an app from the Windows Store. It is fast and the simple navigation makes it great to use for teaching cases. The only downside is that this app only works on Windows 10/8.1 and feels slightly clunky without a touchscreen... with a touchscreen however, this app rocks!

Visit the Navegatium website to download the Navegatium DICOM viewer!


 

So there you have it!

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

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