A Chef's Guide to Working with DICOM Web Server with Orthanc and DCM4CHE

Why This Article?

Orthanc is an open source DICOM server and it is powerful enough to be used as a small group DICOM PACS. It comes with a Web based viewer making it extremely easy to implement a "zero footprint" mini PACS environment. On this article, I will provide the steps on how to get Orthanc up and running and configure a DICOM Web server.

While all the information is out there, here is my Cookbook instructions to get all of that going, so here it is. 


On this edit, I will focus on configuring the entire system on Mac OS. It can also configure on Windows and Linux.

Download and Install Orhanc

Try and Run It - Out of the Box!

It should run completely out of the box without any configuration. For Mac users, I would open a shell in the directory and find startOrthanc.command and just run that command.

If it starts, you should see the Orthanc has started logged on your shell.

Pull up a web browser then type in http://localhost:8042  (Note: 42 in 8042 has a deep meaning and is not advisable to change).  If you see the page below you are good to go. At this point of time there is no DICOM exam on the database so do not dismay or panic if you don't see any. But if you want to download some safe DICOM sample files, get those from http://www.barre.nom.fr/medical/samples/ and using the Upload button on MyOrthanc page, you can try loading some data. We will upload one later on this article so you can wait until then.

Configuring and Testing DICOM Web Server

Right out of the box, DICOM Web is not just enabled but the library comes with it.  All you have to do here is to enable it.

All of the following is described officially in http://book.orthanc-server.com/plugins/dicomweb.html  The purpose below is to clarify and illustrate a bit.

Edit  configOSX.json (or config.json for other platforms) and Insert the DICOM Web Plug-In

See what I did at Line 43. The lib file is included in your distribution.

Add the DICOM Web Configurations

You can put in the DicomWeb section anywhere within the top level. But that's hard to describe exactly where that is. So, just put the block immediately after UnkonwSopClassAccepted configuration, for example. You are seeing a lot of red squiggles in the image below because Orthanc JSON file allows comments, so it is not a pure JSON! Do not worry if your IDE does the same. 

Note DO NOT FORGET TO  ADD a Comma (,) at the end of the section! You will get a Syntax error when you launch Orthanc.

Test the DICOM Web Service

For this test I will use stowrs from dcm4che3 binary. It is a Java based DICOM tools you can easily obtain from the SourceForge at https://sourceforge.net/projects/dcm4che/files/dcm4che3/.  I am using 5.17 when I last checked this document, and I will use This Chest CR Image (attached at the bottom of this article). CR.dcm

Create Your Own DICOM Image From Photos

If you are interested in creating your own DICOM MultiFrame objects from mobile MP4 videos, read my article on How to Create a JPEG Base Encoded Multi-Frame DICOM Object from an MP4 Video

Note that we have configured the dicom-web root URL, and added /studies which is part of the STOW-RS DICOM standard resource.

Now you can go back to the Orthanc page and see the image!

Open the browser at http://localhost:8042 and when it is open, click All Studies. Follow the images below to see the study using the Osimis web viewer.

Please write in your comments if any of these are not clear. I will continue to update by addressing questions.