Why should I use ORTHANC?

I came across ORTHANC while learning about DICOM and PACS. I was demanded to build a system for a medical center in my city that will help them put their doctors to make the reports remotely. So the idea is that the equipments will take the images, send to a PACS server and then the medical center will be able to chose the doctor to write the report.

Since ORTHANC already provides the DICOM archiving and handling, I thought I could use it as a back-end, then build my system on top of it (adding access user control, doctors management etc).

But I am still not sure if I really need to use ORTHANC. I keep asking myself: What if I build a CRUD + Uploading system for DICOM files in my system? It’s basically what I need; A way to store and retrieve DICOM files.

So I came here to ask for your opinion: What is the point of ORTHANC? Why should I use it instead of building my own archiving and retrieving system? Is there any big advantage of using ORTHANC (other than save time)? Does it do things “under the hook” that I don’t know?

Thanks in advance for any help.

I see one of the biggest advantages is that ORTHANC is already support DICOM protocol, allowing the communication between clients and server. This is a thing!


It is not up to our community to convince you to use Orthanc in your very specific project. This is your own responsibility.

First learn how to use the system, how to connect it to your DICOM modalities (DICOM protocol), and how to interface your application with Orthanc (REST API):



Afterwards, you’ll be able to decide by yourself whether Orthanc is a good match to your needs.


Hi Sébastien, thanks for your answer.

I know it’s no up to you, I’m just genuinely asking your help on evaluate if I really need Orthanc.

I have been learning about Orthanc the past 2~3 weeks, I’ve virtually read all the official documentation. It’s a great system and I see a lot of value on it.

I just wanted to make sure it’s the best solution for me as well.

As I’ve learned, there are 2 main advantages to use Orthanc:

  1. It has a good REST service
  2. It’s already implemented the DICOM protocol
  3. It’s already done and tested by hundreds (thousands?) of users
    I just need a way to storage and retrieve DICOM files. I could build a simple CRUD + uploading system to achieve this task.

This is why I asked:

  • What are the biggest advantages of using Orthanc?
  • What are the things it implements that would be complex or painful to implement myself?
  • Does it implement (or make use of) any relevant standard (other than DICOM)?
  • Maybe something related to security?

Thanks again for your help!

And thanks for your contribution on building Orthanc :wink:

Hi, Thiago!

Orthanc’s support of DICOM protocol is a huge thing in itself. Plus, I believe for equipments (aka modalities) you’ll need to interface with DICOM interfaces when dealing with Worklists. Previously I’ve had a tad more experience with Java but boy how hard was it to find a free and easy to use API; with readily available documentation, that is. Orthanc has it.

To send images to the PACS server you’ll have to provide them with a Worklists service first and that equipment/service interface is most probably DICOM. That said, you don’t need Orthanc to be a Worklists server; for instance, I’m working on a proxy-like service plugin. Having the ability to use Orthanc as a PACS and then create a Worklists proxy is invaluable. That is so because we can leverage each technology’s strength to their full potential.

Where I believe Orthanc truly shine is in a HIS / RIS / PACS context: its plugin system makes it very very versatile.

Finally, as Sébastien said, you should get yourself acquainted with it and exercise your product’s requirements. You will then have made the best assessment possible.


Thanks for your response, Luiz.

Yeah, definitely the DICOM protocol support is a big win for Orthanc.

I’ve never worked in med tech before, so I am not as familiar with modalities. But as I understand, given that Orthanc supports (out of the box) the DICOM protocol, I can setup a PACS server using Orthanc and make my modality to send the images directly to the server using the DICOM protocol. Am I right?

PS: Are you from Brazil?

Thiago Régis

Yes to both =)

You can have your modalities send images to Orthanc, that is at its raison d’être, so to speak. But first said modality must query a worklist service to know some basic data (HIS data: patient, for instance) that’s embedded in each image. Orthanc can be a Worklists server through plugins.


Ok, got it. I think the modalities are already currently integrated to the HIS. Then I just need them to upload to Oethanc using DICOM protocol.

Thanks for the clarification, Luiz. I think this is a resounding “yes” for Orthanc :slight_smile: