The best free software solutions for DICOM images

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Sometimes it's useful to be able to view and manipulate medical images such as X-rays, CT or MRI scans on your own PC, laptop or tablet. This is particularly important when preparing teaching files or practising for your radiology exams. Finding a good free DICOM viewer can be tricky, especially as there are so many options out there. We have tested may different applications (so you don't have to) and the following are our best picks. We grouped them according to the operating system used because unfortunately there aren't any free viewers that run on both!

A popular software for radiologists working in the UK is currently a programme called 'Horos'. This is a free open source version of the software used by the Royal College of Radiologists for the viva part of the Final FRCR 2B exam, so obviously it makes sense to use it for teaching as well. This programme is only available on Apple computers, hence why so many radiologists own MacBooks.

There is a paid version of Horos called 'OsiriX MD', which is produced by Pixmeo, however it is expensive so not ideal for basic teaching purposes, although has great functionality. Pixemo also produce a free demo version called 'OsiriX Lite', however there are major limitations placed on this including pop-ups asking you to upgrade to the paid version, performance restrictions, image viewing restrictions and inability to edit the meta-data attached to DICOM images - for example you can't easily re-order series within a study, which may be important if you are preparing cases for teaching or examinations. It is for these reasons that we do not list OsiriX Lite in our recommendations.

• The OsiriX UK user group are a group of Radiologists in the UK who are keen on digital radiology education and use OsiriX/Horos for teaching. The aim is to achieve a nationally agreed consensus on how cases are collected, organised and used for teaching and examination and thereby achieve a collective common ground/platform/standard for radiology education across the country. The resources on this site are amazing so we recommend you visit it now!

Software for Apple MacOS

Radiology Cafe's top pick:

Main features

• Intuitive user interface and customisable toolbars
• 64-bit
• Advanced manipulation and measurement tools
• Multi-planar reconstruction (MPR) with thick slab (Mean, MIP, Volume Rendering)
• 3D MIP, 3D Volume rendering, 3D surface rendering
• Image fusion for PET-CT & SPECT-CT
• Reads and displays all DICOM files
• DICOM Editing
• OsiriX migration assistant
• Separate iOS app to view DICOM on mobile devices (requires iOS 13.0 or later)

System requirements

• OS: MacOS 10.11 or later

Horos should run on any Mac brought within the last 3 years.

Why we like it

We really like Horos as it is a free open source version of the same software as that used by The Royal College of Radiologists for the viva part of the final FRCR (Part B) exam. Becoming familiar with Horos will help radiology trainees when preparing for this exam. Horos is easy to use and as a full 64-bit medical image viewer for Mac there is a huge amount of functionality contained within. It is updated regularly. We believe Horos is the best free DICOM viewer for Apple MacOS.

Interestingly, Horos is named after the Egyptian god Horus, son of Osiris and Isis. Horos is a based on OsiriX (a similar paid-for medical viewer), named after Osiris. The developers obviously appreciate Egyptian and greek mythology!

Visit the Horos website to download the Horos DICOM viewer!

• There is a useful Mac plug-in for Horos that allows you to quickly upload selected studies / images to Radiopaedia, a free educational radiology resource with one of the web's largest collections of radiology cases and reference articles.
• User guide and installation guide:
  https://radiopaedia.org/blog/radiopaedia-plugin-for-horos-osirix

Software for Microsoft Windows

Radiology Cafe's top pick:

Main features

• Simple and intuitive interface with full-screen mode
• Standard manipulation and measurement tools
• Browse several series concurrently in multiple windows with automatic synchronization between series and cross reference lines in series with different image planes
• Display of dynamic sequences/series (CINE)
• Multiplanar Reconstruction (MPR)
• Fusion of series with different modalities (e.g. PET-CT) or different protocols (e.g. MRI T1/T2–DWI)
• Huge range of DICOM file types supported and support for DICOM overlays
• Export DICOM files to JPEG, BMP and WMV.
• Copy and paste directly into Word or PowerPoint documents
• Read DICOM studies from CD/DVD/BluRay disks and local or network folders
• Asynchronous reading (browse images while they are being opened)
• Multi-core and multi-processor support, and advanced memory management system which facilitates concurrent opening of studies with thousands of images
• Universal installer (32 and 64-bit)
• Multilingual interface (>20 languages)
• Multi-touch support
  more feature details...

System requirements

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• OS: Windows 10/8.1/8/7/Vista/XP (SP3)
• Processor: Intel or AMD 1GHz or faster (multicore Intel processor recommended)
• Memory: 512MB of RAM (2GB recommended)
• Hard Disk Space: 9MB of available hard-disk space for installation; additional free space required for image caching
• Screen Resolution: 1024x768 minimum

Why we like it

We really like RadiAnt as it is free, simple, easy to use and very fast. Watch this YouTube demonstration video to see RadiAnt in action. It is downloaded as a single compact application with an installer size of approximately 5MB. The application can even run directly from a USB stick! This basic DICOM viever does all the things you would expect and is perfect for revision purposes for radiology trainees.

Visit the RadiAnt website to download the RadiAnt DICOM viewer!

Radiology Cafe's one to watch:

Main features

• Designed mainly for CT and MR DICOM modalities
• 3D reconstruction and volume rendering
• Multi-planar and oblique slicing
• Easily anonymize and de-identify patient scans
• Fast surface extraction and export to STL and PLY formats
• Load DICOM data directly from PACS, CD/DVD, USB or local computer
• Patient search to locate patient data on your PACS
• Loads common non-DICOM file formats: NifTi (.nii), Visualization Toolkit (.vtk), and ANALYZE (.hdr)
• Window/level (brightness and contrast) presets
• Screen capture
• Axis-aligned cropping with context
• Side-by-side comparative assessment
  more feature details...

System requirements

• OS: Windows 10/8.1
• Processor: Intel i3 or AMD Ryzen 3 (64-bit CPU for data sizes over 100MB)
• Memory: 8+ GB of RAM
• Hard Disk Space: 1GB of available hard-disk space for installation; additional free space required for image caching
• Screen Resolution: 1920x1080 or better

Why we like it

We like Pro Surgical 3D as it is fast and easy to use. Although it is designed for surgeons, it's easy to view patient scans quickly. It works well with studies on CD/DVDs, USB sticks and local DICOM files.

Visit the Pro Surgical 3D website to download the Pro Surgical 3D DICOM viewer!

Online Software

Radiology Cafe's top pick:

Main features

• Unlimited cloud storage space to store medical images
• Multi-platform (Windows, MacOS, Linux, IOS, and Android) Support
• Upload, store and view DICOM files
• Fast Cloud DICOM imaging loading
• Automatic synchronization of compatible series with showing cross-reference lines
• Standard measurement tools
• Multiplanar Reconstruction (MPR)
• View DICOM metadata
• Share, tag and comment on cases with other professionals
• Enter custom descriptions to cases
• WebGL browser rendering
• PACS integration using the Collective Minds® Proxy
• One click case upload using the Collective Minds® Proxy
  more feature details...

System requirements

• The following operating systems and internet browsers are supported:
  • Windows: Google Chrome, Mozilla Firefox
  • Mac OS: Apple Safari, Google Chrome
  • Linux: Google Chrome
  • iOS: Apple Safari, Google Chrome
  • Android: Google Chrome

Free Software For Mac

Why we like it

We really like Collective Minds Radiology as it is a bit different to other sites. It's a radiology collaboration service and centered around sharing cases with other professionals for expertise, advice or teaching. It is free with unlimited storage, easy to use and fast. As it is cloud based, you can access it on pretty much any device. The service is restricted to medical professionals and sharing can be done to specific groups e.g. your hospital community. The ability for users to comment and tag images is particularly unique and great for learning and teaching.

Visit the Collective Minds website to use the Collective Minds Radiology viewer!

Radiology Cafe's alternative recommendation:

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Main features

• Free 50GB cloud space to store medical images and clinical documents
• Multi-platform (Windows, MacOS, Linux, IOS, and Android) Support
• Upload, store and view DICOM files
• Upload, store and view non-DICOM clinical documents which are in PDF, BMP, PNG, JPG, MP4 and AVI formats
• Automatic synchronization of compatible series with showing cross-reference lines
• Standard measurement tools
• Ability to anonymize patient data before uploading
• Share patient images with doctors, medical groups, and patients by sending a viewing link and password
• Organize patients into folders and enter custom descriptions to them
• Multiplanar Reconstruction (MPR)
• Maximum Intensity Projection (MIP), Minimum Intensity Projection (MinIP), Average Intensity Projection (AvgIP)
• 3D Reconstruction
• PET-CT, and PET-MR fusion
• Create user groups and manage user Authorizations
• Recycle Bin to prevent accidental deletion
  more feature details...

System requirements

• The following operating systems and internet browsers are supported:
  • Windows: Google Chrome, Mozilla Firefox
  • Mac OS: Apple Safari, Google Chrome
  • Linux: Google Chrome
  • iOS: Apple Safari
  • Android: Google Chrome

Why we like it

We really like PostDICOM as it is free (up to 50GB online storage), simple, easy to use and fast once the DICOM images are uploaded. As it is cloud based, you can access it on pretty much any device. This DICOM viever does all the things you would expect and is great for sharing studies.

Visit the PostDICOM website to use the PostDICOM viewer!

So there you have it!

Radiology Cafe's 'top pick' and 'one to watch' free DICOM viewers for Microsoft Windows, Apple MacOS and online. Please send us your suggestions for other great free DICOM viewers!