OsiriX HD User Manual


OsiriX HD is an application written for iOS devices.

Copyright 2011-2014 Pixmeo SARL



The Database button displays the list of studies stored locally on your iOS device.

Tap on any of them to display the list of Series it contains.

In the Series list, tap a thumbnail to load the Series in the Viewer. The loaded Series will appear in the database with a little green viewer icon, making it easier to locate.

Adding Images

To add images please refer to the Images Transfers section.

Create secondary capture

Available as In-App Purchase

You can use the device camera to add secondary captures to a study. To do so, open the study and tap the "+" button at the bottom of the series list.

If needed, unlock the "Create secondary capture" feature (via In-App Purchase).

You will then be able to choose a photo from your photo library or to take a picture with the camera. A new series will be created with the selected image.

Deleting Series

Series can be manually deleted from a Study.

To do so, tap and hold the thumbnail of the series to be removed. An alert will ask you to confirm the deletions of the selected series.


OsiriX HD cannot display images greater than 1536x1536 pixels.

To display images with one dimension greater than 1536 pixels, OsiriX HD will resize the image to make it smaller or equal to 1536. In that case, OsiriX HD will display the following warning message:

Image NOT at full resolution.


Here is a quick description of the Viewer features:

Image Manipulation

The image manipulation tool allows you to change the window level and width, zoom in and out, rotate and pan the image. This tool is selected by default.

With one finger, you can:

With two fingers, you can:

Series selection

Only available on iPad

By pressing on this icon, a list of all series and studies available for the current patient is displayed. You can either press on a thumbnail or drag and drop the thumbnail on the view where you want to display the series.

If two views are displayed (see 2nd viewer), you have to drag and drop the thumbnail to change the content of the second viewer.

2nd viewer

Only available on iPad

You can either display a unique viewer or two viewers on the screen. By displaying a second viewer, you can compare a different study of the same patient, or you can view two series of the same study.

If the series are from the same study, and if the 3D references are available in the DICOM files, the cross reference lines are displayed:

To change the content of the viewers, use the series selection button (see Series selection).

You have to drag and drop the thumbnail to change the content of the second viewer by using the series selection button.

Multiplanar Reconstruction (MPR)

Tapping on the orientation button allows you to change the orientation of the series. Keep tapping on the button to cycle through the 3 orientations: Axial, Sagittal and Coronal.


PET-CT blending

Only available on iPad

Available as In-App Purchase

You can fuse pre-registred PET-CT series. To do so, open the CT series and the PET using the 2nd viewer. Once the "PET-CT blending" feature is unlocked (via In-App Purchase), the PET series will be fused on the CT series.


Two different tools are available: length and area.

For both tools:

When you use these tools, an information bubble appears. This bubble displays the data of your measurement (such as length, area, mean, standard deviation, min and max values). You can move this bubble using one finger and minimize it with a double tap (single tap on the mini-bubble to maximize it).

To change the color of the measurements, see the Settings section.

Images Transfers

OsiriX HD being a DICOM compliant device, all transfers are done through the DICOM protocol.

These protocols are supported: C-STORE SCP, C-GET SCU, C-MOVE SCU, C-FIND SCU, WADO.

In order to add your iOS device to an existing DICOM network, you will need:

Once your device is connected to the network, you will need to declare it as a DICOM node on the DICOM network. If you have a Mac running OsiriX 3.8 (or higher), you can directly go to Connecting to the Mac. Otherwise, you will need to get the following information and ask your network manager to add your iOS device to the DICOM network:

This information is available in the "Q&R" tab of OsiriX HD:

Once the device is declared as a DICOM node, it can receive images from other DICOM workstations on the network. Of course, OsiriX HD needs to be launched on your device in order to listen to incoming DICOM communications.

Standard DICOM Query and Retrieve

DICOM Q&R configuration

OsiriX HD supports the standard DICOM Query and Retrieve protocol. This feature allows you to search for and retrieve images from a PACS server or a DICOM-compliant Workstation from your device and directly download them to OsiriX HD database on your iOS device.

To enable this feature, you will need to specify a new "DICOM Server" (such as a PACS Server) in your DICOM Q&R list.

First you will need to ask you PACS or IT manager the following information about the DICOM Server you want to connect to:

To add the new DICOM server to your list, proceed as follows:

Fixed IP address?

When you download images from a DICOM Query & Retrieve request, you will require a fixed IP address, if you use the C-MOVE SCU protocol.

You will not require a fixed IP address, if you use the C-GET SCU or WADO protocols.

In most situations, your iOS device will have a different IP address when you turn it on, or when you switch to or from a different network protocol (WiFi, 3G/4G, VPN).

Most VPN will provide a different IP address, but in rare cases, VPN can be configured to have always the same IP address (ask your IT manager for more informations).

Hence, it is highly recommended to use the C-GET SCU or WADO protocol, instead of the C-MOVE SCU protocol, if the distant DICOM Node supports them.

OsiriX for OS X supports all these protocols.

DICOM Q&R usage

You can now select the DICOM server that was added to the list. On the next screen you will be able to set the search criteria (filter) for retrieving the images you want from the remote server or workstation. The fields that can be used for search criteria are:

You can fill multiple criteria for more selective search.

Then tap the "Query" button in the lower right corner. The result of your search will be displayed as a list of studies.

You can also create presets (aka filters): for example, you can have a filter for CT for the modality and Today for the date. Simply add a word in the "Add as..." area, and your preset is created. You can then press on it to apply it. To delete a preset, tap the "Edit" button in the upper right corner.

To retrieve a particular Study, select it in the list and tap the "Retrieve Study" button located in the lower right corner.

To retrieve one or more Series of a Study, select the Study from the list and the select the Series (a green check mark will be display) and tap the "Retrieve Selected Series".

The new images will progressively be transferred and added to your local database (tap the "Database" tab to select them for display).

Send images from OsiriX HD

OsiriX HD supports DICOM C-Store SCU protocol. That means you can send DICOM images stored on your OsiriX HD database to any DICOM nodes, including another OsiriX HD iOS device, OsiriX, a DICOM viewer, or a PACS server.

To send an entire DICOM series, simply display it in the Viewer. Then press the Send icon, located on the upper right position in the toolbar.

Select or add a DICOM Node destination.

The images are sent in the background.

Connecting to the Mac

Sending images from the Mac to the iOS device

To send images from your Mac:

When OsiriX HD is open on your iOS device, it will appear in the "Sources" list of OsiriX on the Mac. To send images, you simply have to drag and drop them on the device in this list.

Requesting images from the Mac on the iOS device

From the "Q&R" tab, you can directly ask your Mac to send you images:

Then go to the "Q&R" tab of OsiriX HD on the iOS device. Your Mac will appear in the servers list.

If your Mac is not on the same subnet, you can still add it manually using the "Edit" button of the "Q&R" interface.

Once you get your Mac on the list, select it and you will be able to remotely browse the content of its OsiriX database and transfer images that you need.


When you send images to your iOS device, you should keep in mind that:

File Sharing

OsiriX HD supports the File Sharing function of iTunes: you can easily copy files from your computer to your iOS device, through your USB connection.

If you need to copy large amount of files, this function is faster than transferring the images through DICOM protocol on a WiFi network.

You can copy different types of files with this function:

More informations about iOS File Sharing is available here.

MIME types support

You can use OsiriX HD as an application helper for other applications installed on your iOS device.

For example, this function is useful if you receive an email containing a zip file with DICOM files, if you want to open DICOM files from your Dropbox account, or if you want to view a DICOM file directly from Safari ... Password protected ZIP are also supported.

Currently there are four MIME types supported:

To transfer images through your Dropbox account:

osirix:// URL scheme

In iOS, an application is able to “bind” itself to a custom URL scheme. Using that scheme you can launch this app from a web browser or from another application on the device.

This feature allows to integrate OsiriX HD to virtually any other iOS app or web site.

In current version three methods are supported through the osirix:// URL scheme:

This feature allows to use OsiriX HD as a complementary viewing program to any EMR, RIS, HIS, ...


The settings of OsiriX HD can be found in the "Settings" application of your iOS device.

It contains the following options:


JPEG2000 compression protocol is supported on all 'retrieve' modes: C-MOVE, C-GET and WADO. It greatly increases network performances.

If you use OsiriX for OS X: for JPEG2000 with C-GET, don't forget to activate in OsiriX for OS X: Preferences Listener: Preferred Syntax: JPEG2000 Lossless and Lossy, instead of Explicit Little Endian.

For the WADO protocol, the default stored syntax (original syntax) will be used. That means these files need to be stored as JPEG2000 on the server, to be retrieved as JPEG2000.

For C-MOVE, the defined syntax in OsiriX HD listener will be used (by default JPEG2000): see Settings.


If you transfer and store non-anonymized DICOM files to your iOS device, you have to care about security!

There are a few small settings that can transform your iOS device in a safe storage media:

Bug Report

If you experience crashes with OsiriX HD on your iOS device, you can help us solve those issues by sending us your crash reports.

These crash reports are stored on your iOS device at the time of the crash. When you sync your device with iTunes, the reports are copied to your computer to the following folder:

The files will start with the name of the application and contain a date stamp. All crash reports starting with "OsiriX HD..." might be helpful for us.

Please send your crash reports to iphone@pixmeo.com


If you can't find the answer to a question in this Manual, please e-mail us at: