An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through 2019b. The preamble of a DICOM file that complies with this specification can contain the header for an executable file, such as Portable Executable (PE) malware. This space is left unspecified so that dual-purpose files can be created. (For example, dual-purpose TIFF/DICOM files are used in digital whole slide imaging for applications in medicine.) To exploit this vulnerability, someone must execute a maliciously crafted file that is encoded in the DICOM Part 10 File Format. PE/DICOM files are executable even with the .dcm file extension. Anti-malware configurations at healthcare facilities often ignore medical imagery. Also, anti-malware tools and business processes could violate regulatory frameworks (such as HIPAA) when processing suspicious DICOM files.

An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through 2019b. The preamble of a DICOM file that complies with this specification can contain the header for an executable file, such as Portable Executable (PE) malware. This space is left unspecified so that dual-purpose files can be created. (For example, dual-purpose TIFF/DICOM files are used in digital whole slide imaging for applications in medicine.) To exploit this vulnerability, someone must execute a maliciously crafted file that is encoded in the DICOM Part 10 File Format. PE/DICOM files are executable even with the .dcm file extension. Anti-malware configurations at healthcare facilities often ignore medical imagery. Also, anti-malware tools and business processes could violate regulatory frameworks (such as HIPAA) when processing suspicious DICOM files. Credit for the discovery of this vulnerability goes to Markel Picado Ortiz (d00rt) of Cylera Labs.