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DICOM file security: How malware can hide behind HIPAA-protected images


A DICOM file is an image from a medical scan saved in the Digital Imaging and Communications in Medicine (DICOM) format. DICOM is the international 30-year-old standard protocol for managing and transmitting medical images, such as ultrasounds, MRIs, X-rays, and CT scans. In addition, these files often include the patient’s identification data, including name, age, date of birth, height, weight, and medical condition. DICOM files facilitate the digital transfer of these images and related data between healthcare entities, eliminating the need for physical films and avoiding compatibility issues.

In 2016, the Box DICOM Viewer – a cloud-based solution designed to enable storing, sharing and viewing any DICOM file on a browser or mobile device – was approved as a class II medical device by the Food and Drug Administration (FDA). As a class II device, medical professionals can use the Box DICOM Viewer for diagnostic purposes. FDA approval was granted after a three-year process during which Box had to demonstrate that through the entire process of uploading, storing, sharing, accessing, viewing, and downloading a DICOM file, there would be no...

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