DICOM to Azure
Send DICOM to Azure Health Data Services
Route studies from modalities and PACS into the Azure DICOM service, and query, retrieve, and edit them afterwards — with rule-based routing, HL7 awareness, and store-and-forward retry.
The basics
How do you get DICOM into Azure?
The Azure DICOM service, part of Azure Health Data Services, stores imaging over DICOMweb — STOW-RS, QIDO-RS, and WADO-RS — behind Entra authentication. Modalities speak classic DICOM C-STORE and know nothing about any of that, so a bridge is required between the imaging network and the cloud endpoint.
RadFuzion is that bridge. Modalities and PACS send to it as an ordinary DICOM node; it applies routing rules and stores studies into the Azure DICOM service, then lets you query, retrieve, and correct what is there.
Why RadFuzion
A production path, not a one-off upload
Uploading images is straightforward until the link drops, the metadata is wrong, or you need a study back. Those are the cases that decide whether a cloud archive is usable day to day.
Modalities send DICOM as usual
C-STORE in, DICOMweb out. RadFuzion handles the Azure endpoint and its authentication, so nothing on the acquisition side needs to know the archive moved.
Query, retrieve, and view
Search the Azure DICOM service and pull studies back for comparison or correction, including into the browser viewer.
Survives a bad link
Studies are stored locally and forwarded automatically when Azure is reachable again, so an outage becomes a delay rather than a failure.
Under the hood
Azure DICOM capabilities
- check_circleSTOW-RS store to the Azure DICOM service
- check_circleQIDO-RS query against Azure
- check_circleWADO-RS retrieve for viewing and priors
- check_circleReceive from modalities by C-STORE
- check_circleRule-based routing to Azure and elsewhere
- check_circleHL7-driven routing decisions
- check_circleTag correction before or after upload
- check_circleEdit studies already in Azure
- check_circleTransfer-syntax conversion and compression
- check_circleStore-and-forward retry on outage
- check_circleMulti-cloud: Azure, Google, S3 together
- check_circleCentral management across sites
Running Azure alongside what you already have
Cloud adoption in imaging is rarely a clean switchover. A site typically runs an on-prem PACS and a cloud archive together for a long stretch — for migration, for redundancy, or because different service lines moved at different speeds. Because routing is rule-based, one inbound study can be written to Azure and an existing PACS at once, which makes a parallel run a configuration choice rather than a project.
That also makes the cutover reversible. If the cloud destination needs to be paused, the rule changes and studies keep flowing to the existing archive, with anything queued for Azure forwarding when it returns.
FAQ
Azure DICOM questions
How do I send DICOM from a modality to Azure?add
Point the modality at RadFuzion as a standard DICOM destination using C-STORE. RadFuzion stores the study into the Azure DICOM service over STOW-RS, handling the endpoint, authentication, and retry, with no change on the modality.
Can I query and retrieve from the Azure DICOM service?add
Yes. RadFuzion queries with QIDO-RS and retrieves with WADO-RS, so studies in Azure can be pulled back for viewing, prior comparison, or correction.
What happens when Azure or the network is unavailable?add
Studies are held locally and forwarding retries automatically until the service is reachable. The modality receives a successful C-STORE, so acquisition is never blocked by a cloud outage.
Can I send to Azure and my existing PACS at the same time?add
Yes. A single routing rule can target multiple destinations, so one inbound study can land in the Azure DICOM service and an on-prem PACS together — which is how most sites run a migration or keep redundancy.
Can tags be corrected on the way to Azure?add
Yes. Routing rules apply tag modifications in flight, and RadMatch normalizes free-text study descriptions to your exam codes, so the cloud copy is consistent rather than inheriting whatever the modality wrote.
Does RadFuzion support other clouds as well?add
Yes. The same rule engine routes to Google Cloud Healthcare DICOM stores, generic DICOMweb endpoints, Amazon S3, local storage, and traditional DICOM PACS — in any combination.
See multi-cloud routing
Open the live preview to see one ruleset route studies across cloud and on-prem destinations.