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

PURPOSE: 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.
METHODS: 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.
RESULTS: 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. DISCUSSION: 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.