Cybersecurity and Medical Imaging: A Simulation-Based Approach to DICOM Communication

Stylianos Karagiannis, Emmanouil Magkos, Christoforos Ntantogian, Ricardo Cabecinha, Theofanis Fotis

Research output: Contribution to journalArticlepeer-review


Medical imaging plays a crucial role in modern healthcare, providing essential information for accurate diagnosis and treatment planning. The Digital Imaging and Communications in Medicine (DICOM) standard has revolutionized the storage, transmission, and sharing of medical images and related data. Despite its advantages, implementation and deployment of the DICOM protocol often suffers from incomplete understanding, leading to vulnerabilities within the healthcare ecosystem. This research paper presents an implementation of DICOM communication and the development of a practical demonstration for simulation purposes The simulation can be used for conducting cybersecurity tests in the context of DICOM communication. Overall, the simulation provides a digital environment that can help in retrieving valuable insights into the practical aspects of DICOM communication and PACS integration, serving as a valuable resource for medical imaging professionals, researchers, and developers. These research results provide practical insights, and the DICOM simulation can be used in realistic contexts to showcase a variety of security scenarios.
Original languageEnglish
Article number10072
Pages (from-to)10072
Number of pages22
JournalApplied Sciences (Switzerland)
Issue number18
Publication statusPublished - 6 Sept 2023

Bibliographical note

Funding Information:
This work was funded by the European Union’s Horizon 2020 Research and Innovation Programme under Grant Agreements No. 883273 (AI4HEALTHSEC) and No. 101070450 (AI4CYBER).

Funding Information:
The authors would like to acknowledge support and funding provided by the projects AI4HEALTHSEC and AI4CYBER.

Publisher Copyright:
© 2023 by the authors.


  • medical imaging
  • PACS
  • eHealth
  • simulation


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