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 '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.

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 free version including adding 'NOT FOR MEDICAL USE' in red letters to every image, pop-ups asking you to upgrade to OsiriX MD, performance restrictions, image viewing restrictions and inability to 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 that we have removed OsiriX Lite from our recommendations.

 

 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 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 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


 

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:


Pro Surgical 3D DICOM viewer screenshots

Pro Surgical 3D DICOM viewer screenshots

 

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...

 

Pro Surgical 3D DICOM viewer screenshots

Pro Surgical 3D DICOM viewer screenshots

 

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

 

Pro Surgical 3D logoWhy 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.  The only downside is that this app only works on Windows 10/8.1.

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


 

Radiology Cafe's worth a look:


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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