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Security of patient and study data associated with DICOM images when transferred using compact disc media.
J Digit Imaging. 2009 Mar; 22(1):65-70.JD

Abstract

The transmission of patient and imaging data between imaging centers and other interested individuals is increasingly achieved by means of compact disc digital media (CD). These CDs typically contain, in addition to the patient images, a DICOM reader and information about the origin of the data. While equipment manufacturers attach disclaimers to these discs and specify the intended use of such media, they are often the only practical means of transmitting data for small medical, dental, or veterinary medical centers. Images transmitted by these means are used for clinical diagnosis. This has lead to a heavy reliance on the integrity of the data. This report describes attempts to alter significant patient and study data on CD media and their outcome. The results show that data files are extremely vulnerable to alteration, and alterations are not detectable without detailed analysis of file structure. No alterations to the DICOM readers were required to achieve this; changes were applied only to the data files. CDs with altered data can be readily prepared, and from the point of view of individuals viewing the images, function identically to the original manufacturer's CD. Such media should be considered unsafe where there is a potential for financial or other gain to be had from altering the data, and the copy cannot be cross-checked with the original data.

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Authors+Show Affiliations

McEvoy FJ
Department of Small Animal Clinical Sciences, Faculty of Life Sciences, Frederiksberg Campus, University of Copenhagen, Copenhagen, Denmark. fme@life.ku.dk
Svalastoga E
No affiliation info available

MeSH

Compact DisksComputer Communication NetworksComputer SecurityHumansInformation Storage and RetrievalMedical Records Systems, ComputerizedRadiology Information Systems

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17710493

Citation

McEvoy, Fintan J., and Eiliv Svalastoga. "Security of Patient and Study Data Associated With DICOM Images when Transferred Using Compact Disc Media." Journal of Digital Imaging, vol. 22, no. 1, 2009, pp. 65-70.
McEvoy FJ, Svalastoga E. Security of patient and study data associated with DICOM images when transferred using compact disc media. J Digit Imaging. 2009;22(1):65-70.
McEvoy, F. J., & Svalastoga, E. (2009). Security of patient and study data associated with DICOM images when transferred using compact disc media. Journal of Digital Imaging, 22(1), 65-70.
McEvoy FJ, Svalastoga E. Security of Patient and Study Data Associated With DICOM Images when Transferred Using Compact Disc Media. J Digit Imaging. 2009;22(1):65-70. PubMed PMID: 17710493.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Security of patient and study data associated with DICOM images when transferred using compact disc media. AU - McEvoy,Fintan J, AU - Svalastoga,Eiliv, Y1 - 2007/08/21/ PY - 2007/05/15/received PY - 2007/08/05/accepted PY - 2007/07/24/revised PY - 2007/8/22/pubmed PY - 2009/5/29/medline PY - 2007/8/22/entrez SP - 65 EP - 70 JF - Journal of digital imaging JO - J Digit Imaging VL - 22 IS - 1 N2 - The transmission of patient and imaging data between imaging centers and other interested individuals is increasingly achieved by means of compact disc digital media (CD). These CDs typically contain, in addition to the patient images, a DICOM reader and information about the origin of the data. While equipment manufacturers attach disclaimers to these discs and specify the intended use of such media, they are often the only practical means of transmitting data for small medical, dental, or veterinary medical centers. Images transmitted by these means are used for clinical diagnosis. This has lead to a heavy reliance on the integrity of the data. This report describes attempts to alter significant patient and study data on CD media and their outcome. The results show that data files are extremely vulnerable to alteration, and alterations are not detectable without detailed analysis of file structure. No alterations to the DICOM readers were required to achieve this; changes were applied only to the data files. CDs with altered data can be readily prepared, and from the point of view of individuals viewing the images, function identically to the original manufacturer's CD. Such media should be considered unsafe where there is a potential for financial or other gain to be had from altering the data, and the copy cannot be cross-checked with the original data. SN - 1618-727X UR - https://www.unboundmedicine.com/medline/citation/17710493/Security_of_patient_and_study_data_associated_with_DICOM_images_when_transferred_using_compact_disc_media_ L2 - https://doi.org/10.1007/s10278-007-9068-x DB - PRIME DP - Unbound Medicine ER -