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DICOM Redaction Software

Patient identifiers in a DICOM study live in two places: burned into the pixels, and written into the header tags. Redactor handles both, as separate operations, across multi-frame studies.

Why DICOM Is Not Just Another Image

Most redaction tools treat a medical image as a picture. That misses half the problem and breaks the other half.

Identifiers are burned into the pixel data by the modality itself, often in a corner of every frame. They are also written into the DICOM header as textual tags. A tool that flattens a study to JPEG strips the study and series structure a PACS needs, and a tool that only cleans metadata leaves the patient name visible in the image.

A multi-frame study compounds it. Burned-in text does not necessarily appear on the first frame, so anything that samples one image and moves on will pass a study that is still identifiable.

How DICOM Redaction Works

Redactor treats DICOM as medical imaging rather than as a generic image, preserving study and series structure.

  1. Ingest.dcm, .dic and .dicom are recognized as a distinct medical-imaging content type, not converted to a general image format.
  2. Process frame by frame — each frame of a multi-frame study is treated as one page by the processing pipeline, so burned-in text and objects are detected across the whole study rather than on the first image only.
  3. De-identify the header separately — extraction walks the DICOM tag set and returns the textual, PII-relevant tags, deliberately skipping elements that carry pixel data so imaging content is handled by image redaction rather than by metadata processing.
  4. Redact the pixels — pixel-burned identifiers are obscured frame by frame with a solid fill.

What DICOM Redaction Covers

Extensions.dcm, .dic, .dicom
Multi-frame studiesHandled a frame at a time, one frame per page
Pixel-burned identifiersDetected and masked across every frame
Header tagsTextual PII-relevant tags extracted for de-identification; binary and pixel-bearing elements left to the imaging path
MaskingSolid fill
Clinical narrativeDe-identified with a RoBERTa model trained on the i2b2 clinical corpus, running as a recognizer alongside the general PII pipeline
DeploymentShared SaaS, dedicated SaaS, private cloud, on-premises, air-gapped

Clinical text gets a clinical model

Where a study travels with a report, the narrative is de-identified using a model trained for clinical text rather than a general-purpose PII recognizer. The i2b2 de-identification model recognizes the identifiers that appear in medical records and the forms they take there, which is not the same as the forms they take in a contract or a police report.

Compared With Flattening to Images

Flatten to JPEG or PNGRedactor
Study and series structure lost; output no longer a DICOM studyStructure preserved, output remains DICOM
Header tags carried over or discarded wholesaleTextual tags de-identified as a separate, deliberate operation
First frame sampled, later frames uncheckedEvery frame of a multi-frame study processed
Clinical narrative run through a general PII modelClinical narrative run through a model trained on clinical text

Where It Matters

What DICOM Redaction Does Not Do

  • Blur and pixelate are not available for DICOM. Masking is a solid fill. Blur and pixelate are explicitly deferred in the document masking work.
  • The clinical de-identification model is one recognizer among those the PII pipeline runs; language coverage follows the pipeline rather than the model.
  • Identifiers in the DICOM header and identifiers burned into the pixels are two operations. Running one does not cover the other.

How DICOM Redaction Is Evaluated

  • DICOM is handled as a distinct medical-imaging content type, including multi-frame studies, rather than converted to a generic image.
  • DICOM redaction covers multi-frame studies, processing frame by frame.
  • Headers and pixel data are de-identified as separate operations, because the identifiers live in two different places.
  • A dedicated clinical de-identification model handles PHI, running alongside the general recognizers.
  • Masking for DICOM is a solid fill; blur and pixelate are not offered.
  • Available on-premises and air-gapped, so studies need not leave the organization to be de-identified.

Redact a Study Without It Leaving Your Network

Send us a de-identified sample, or run it yourself on-premises. We will show you both surfaces: the pixels and the tags.