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DICOM server and processing

Status: accepted
Deciders: Original PIXL team
Date: 2023-11-01 (retrospectively)

Context and Problem Statement

We need to have a DICOM server to query DICOM images, store them, anonymise them and export them.

Decision Drivers

Will need to have a robust DICOM server that has been in use
Keep original studies in a cache locally to reduce use of clinical imaging systems if failures in anonymisation or export
The team's lingua franca is Python
Per-project anonymisation profiles and custom hashing of fields will require plugins to be written for anonymisation
UCLH infrastructure allows for running docker, but we don't have admin accounts and cannot install software directly onto the machines.

Considered Options

XNAT server
Orthanc server

Decision Outcome

Chosen option: Orthanc, because it's relatively lightweight, under development and allows for python-based extensions to be written.

Pros and Cons of the Options

XNAT

Good, ARC has a history of using this in the medical imaging subgroup.
Good, widely regarded
Bad, heavyweight and has many more features than we need to use. May take longer to learn and deploy
Bad, does not allow for python-based plugins to be used for anonymisation without getting into running docker in docker

Orthanc

Good, has been battle tested
Good, has DICOMWeb plugin to allow for export via that modality
Good, allows for python-based plugins and running in docker
Bad, no previous usage within ARC. Will be teething problems