Collaboration around medical imaging in the cloud

26/05/2016 | Frédéric Lambrechts | comments

The problem

The number of medical images is exploding; in Belgium alone, 33 million medical imaging exams are carried out every year. Institutions that perform these exams often have multiple medical imaging equipment and servers (PACS or VNA), bought from different competing manufacturers. Since each manufacturer developed its own software and has an own DICOM interpretation, interoperability is very complex. That is why CD’s are created to access the images in the hospital’s PACS system: about 20 million yearly in Belgium. The full cost of burning and shipping one CD amounts to 6,5€ approximately, that is a cost of 130 million € on this process, while the images will not necessarily be viewed by the receiver… In addition to this financial waste, the use of CD’s is not environmentally friendly and inspecting and indexing files stored on CD’s is difficult and time-consuming

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Current ways to manage and share medical images

Next to CD’s, VPN tunnels and custom proprietary codes are currently used for image management inside hospitals, between hospitals, among physicians and for hospital to patient transfer. Unfortunately, these procedures increasingly cause interoperability problems due to highly tailored systems and devices that are impossible to integrate with the proprietary PACS.

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Image management pains

The interoperable solution Orthanc

A simple, powerful and cost efficient way to manage and share medical images was introduced in 2011, by Sébastien Jodogne, member of the Liège University Hospital staff, who created a medical imaging server named Orthanc, initially to respond to the needs of their radiotherapy department.

As the research for these developments had been sponsored by government funds, it was then decided to open up the source code. It has been downloaded by hospitals, radiologists and specialists over 25.000 times ever since.

Orthanc is a free, open-source, lightweight, RESTful, standalone DICOM server enabling easy exchange between departments, physicians and hospitals. The fully self-contained mini PACS system can be downloaded and run immediately. It is possible to drive Orthanc from any computer language thanks to the fact it has a REST API.

Orthanc’s partner Osimis

Osimis was created alongside Orthanc to help it reach a wider market. We help medical specialists and industrials the world over with implementation, management and support for their Orthanc deployments.

Next to these services, Osimis builds software products having Orthanc at its core and addressing specific user needs, ranging from simple Orthanc packaged clients to cloud solutions to image transmission hubs.


One of these products is Orthanc’s packaged version Lify, a cross platform application that can store, share and cloud-synchronise medical images sourced from multiple DICOM sources. Medical images can be stored directly from a DICOM modality and visualized in the cloud. They can be shared with anyone and will be available anywhere by synchronising them in the cloud.

Lify can also integrate with local health networks or electronic health records. Images can be imported by drag and drop or by CD and will be converted to DICOM format. Tags can be added, workflows customized and routing automated. Images are viewable with an advanced 2D viewer, and if preferred, seamless integration with professional viewers is possible. One can generate reports by dragging & dropping annotations or notes made while analysing the series. Before sharing the images, information can be anonymized. Sharing can be done via the cloud or through email. The images can also be shared through ‘liveshare’, a feature that enables different specialists to view a particular study at the same time during a conference call. Studies can be published on a personalised portal. Finally, postprocessing operations such as image segmentation or the creation of 3D images can be applied through algorithms.

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Representation of Lify

Thanks to Lify, we can stop wasting time and money on burning, shipping and reading CD’s, no expensive experts need to be hired to ease integration and other applications can be integrated easily. The application can be customized to fit the exact needs. And believe it or not … most of the functionalities will be available for free, forever!

Check out Lify

Osimis team frederic

Frédéric Lambrechts

A man for whom 24 hours in the day would just be enough, if he could go without sleep. He has a seemingly endless stream of ideas and prides himself on always being on top of everything going on in his company. Frederic used to work as a boring banking consultant until divine inspiration sentenced him to a life of penal servitude to the medical imaging business. But that was just after he learnt the dirty tricks of full stack coding during an excellent 2-month bootcamp.