DICOM Forwarding Setup Guide

DICOM Forwarding Setup Guide

Overview

This guide explains how to configure a DICOM workflow where K PACS sends images to Orthanc, and Orthanc automatically forwards those images to a DICOM Router. This setup is typically used in clinics or hospitals to centralize image routing and automate delivery to backend systems.

Requirements

ComponentDescription
K PACSFree DICOM viewer and sender
OrthancLightweight DICOM server capable of auto forwarding
DICOM RouterDestination system that receives final images
Windows PCFor installing K PACS and Orthanc
Network InformationIP address, port, and AE Title of the DICOM Router

Notes
1. Install K PACS


Download

  1. Visit the K-PACS official website.
  2. Download the latest version of K-PACS Lite.

Installation

  1. Run the installer.
  2. Follow the on-screen instructions.
  3. After installation, launch the K PACS Admin Tool.

Notes
2. Install Orthanc


Option A: Windows Installer

  1. Visit the Orthanc download page.
  2. Download the Windows installer.
  3. Run the installer and complete the setup.

Option B: Docker (Advanced)

If you prefer using Docker, you can run Orthanc using the command below:

docker run -p 8042:8042 -p 4242:4242 jodogne/orthanc

Notes
3. Configure K PACS to Send DICOM Images to Orthanc

  1. Open the K PACS Admin Tool.
  2. Navigate to DICOM Nodes.

  3. Select Add.
  4. Enter the following configuration:

    • AE Title: ORTHANC
    • IP Address: localhost (or your Orthanc server IP)
    • Port: 4242
  5. Save the configuration.
  6. Test the connection using C ECHO.

Notes
4. Configure Orthanc to Forward Images to the DICOM Router

Locate Orthanc.json

File Locations:

  • Windows: C:\Program Files\Orthanc Server\Configuration\Orthanc.json
  • Docker: mount your configuration file or use environment variables.

Add the Following Configuration:

DicomModalities configuration:

"DicomModalities": {
  "DCMROUTER": [ "DCMROUTER", "localhost", 11112 ]
},

Forwarding configuration:

"ForwardDicom": [ "DCMROUTER" ]

Replace localhost and 11112 with the actual IP and port of your DICOM Router.

Notes
5. Enable Auto Forwarding for Web Uploaded Images (Optional)

Create a Lua Script

Save the script below as forward.lua in a directory such as:

D:\RIS_AGENT\scripts\forward.lua

function OnStoredInstance(instanceId, tags, metadata)
  SendToModality(instanceId, "DCMROUTER")
end

Add the Script to Orthanc.json

"LuaScripts": [ "D:\\RIS_AGENT\\scripts\\forward.lua" ]

Note: Use double backslashes for Windows paths.

Notes
6. Restart Orthanc

Windows

  1. Press Win + R and type services.msc.
  2. Locate Orthanc Server.
  3. Right click and select Restart.

Command Prompt (Run as Administrator):

net stop Orthanc
net start Orthanc

Docker

docker restart orthanc

Notes
7. Test the Configuration

Test from K PACS

  1. Send a DICOM image to Orthanc.

  2. Verify the image appears in Orthanc via http://localhost:8042.

Test Orthanc Forwarding

  1. Confirm Orthanc forwards the image to the DICOM Router.


  2. Check the router logs or viewer.

Troubleshooting

IssueCauseSolution
Image not forwardedIncorrect AE Title or network valuesVerify AE Title, IP, and port in Orthanc.json
Web uploads not forwardedLua script missing or not loadedAdd Lua script and restart Orthanc
Router rejects imageAE Title mismatchConfirm router configuration
No response from routerConnectivity or DICOM issueTest using echoscu or storescu

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