Orthanc
Open-source DICOM server from Belgium that works as a mini-PACS and an integration building block
Quick Overview
| Company | Orthanc Team SRL (copyright holder with UCLouvain) |
|---|---|
| Category | PACS and Medical Imaging Software |
| Headquarters | Belgium, Belgium |
| Founded | Not stated |
| EU Presence | Yes - Belgium (EU) |
| Data Location | Wherever you install it |
| Open Source | GPLv3+ (core), AGPLv3+ (selected plugins) |
| GDPR Compliant | Yes |
| Self-Hosting | Yes - Windows, Linux, macOS and Docker |
| Main Features | DICOM server, REST API, web interface, DICOMweb plugin, Stone web viewer, PostgreSQL and MySQL plugins, whole-slide imaging, Python and C++ plugins |
| Pricing | Software is free; support packs from Orthanc Team |
| Best For | Researchers, small practices and integrators who want a controllable DICOM core |
| Replaces | Intelerad IntelePACS (small-scale) |
Detailed Review
The Orthanc homepage calls it free and open-source, lightweight DICOM server for medical imaging from Belgium. The Orthanc Book says the University Hospital of Liege released it under GPLv3+ in 2012.
Intellectual property is now shared by Orthanc Team SRL since 2024, the UCLouvain university since 2021, and individual contributors. Osimis S.A., a previous holder, ceased to exist at the end of January 2024.
A server you can script
Orthanc receives and sends DICOM, offers an ubiquitous web interface and exposes a REST API for automating imaging flows. An SDK lets native applications embed it, and Python and C++ plugins extend it.
Plugins add PostgreSQL and MySQL storage, DICOMweb, the Stone web viewer and whole-slide imaging. The older Osimis web viewer plugin is marked deprecated on the homepage.
Licensing with a purpose
The core is GPLv3+. Plugins that matter for large-scale cloud deployments, such as the PostgreSQL and web viewer plugins, use the stronger AGPLv3+ licence so that changes in server-side deployments flow back to the community.
The Orthanc Book argues that internal use and most commercial deployments are allowed, but anyone who distributes proprietary software linked to it should read the table in the licensing guide.
Support instead of a vendor
Orthanc.Team, run by Alain Mazy and Benoit Crickboom, sells deployment help, integration advice, plugin development and prepaid support hours valid twelve months. Sponsors of the project on Open Collective receive a 10 percent discount on support packs.
Limitations to Consider
Orthanc is a building block rather than a packaged enterprise PACS, and nobody guarantees clinical validation or an uptime service level. The Orthanc Team states that it is not liable for defects in the open-source software. The medical-device status of your deployment is your responsibility. For a certified product, compare Telemis or synedra.
Who Should Use Orthanc
Research groups, small clinics with IT staff, vets and software integrators who want to run and control their own DICOM server.
Pros and Cons
Pros
- No licence fee
- Source code available for review
- REST API and plugins for automation
- Runs on-premises, so images stay where you put them
- Optional paid support from the Orthanc Team
Cons
- Not a turnkey enterprise PACS
- No vendor liability for defects
- Medical-device compliance falls on the operator
- Some plugins are AGPL, which affects redistribution
Alternatives to Orthanc
Other European pacs and medical imaging software worth comparing before you decide:
Telemis
Belgium · Louvain-la-Neuve PACS, multimedia archive and pathology viewer in one family
synedra
Austria · Innsbruck content platform whose PACS is a certified medical device
VISUS JiveX
Germany · Bochum enterprise PACS plus a content system for non-radiology data
Sectra
Sweden · Linkoping enterprise imaging platform sold as subscription cloud or on-premises
See all European pacs and medical imaging software or compare them directly against Intelerad IntelePACS (small-scale) on our alternatives page.
Frequently Asked Questions
Yes, the software is free and open-source. Only optional services such as the Orthanc.Team support hours cost money.
The Orthanc Book says commercial use is accepted, with conditions that depend on the licence and on how a third-party system is distributed. Read its licensing table before building a product.
The Orthanc Book lists Orthanc Team SRL, UCLouvain and individual contributors as the current rights holders, after earlier phases at the University Hospital of Liege and Osimis.