[Use of the DICOM standard in a heterogenous environment. Incompatibility or inoperability?]

The DICOM standard, introduced in 1993, is now established in many of today's image modalities. Experiences with DICOM implementations and requirements for future developments are described.

First a brief summary of the development of the DICOM standard is given. Based on general observations, different problems with installation, programming and maintenance are outlined.

The standard consists of mandatory and optional information models and functionalities to enable the use and development of a broad spectrum of applications. But the available options lead to specific applications not compatible with the basic idea of the standard.

For functional communication distinct DICOM services are necessary. This includes DICOM Basic Worklist, Storage Commitment and Performed Procedure Step. A constructive way to achieve inter-operability through voluntary arrangements between manufactures and users will be shown.