In my opinion you don’t have the ideal tool. Orthanc’s strength is storing and transporting images. ImageJ will let you work on the image itself and then save it.
Dicom is a header followed by the data itself. The different tags are part of the header and the final tag signifies the beginning of the actual data.
We have a plugin to ImageJ which will read and write to the Orthanc server (http://petctviewer.org). This way you get the best of both worlds. In the software there is a Dicom write which lets you write out your modified data.