dcmclient — DICOM workflows from the command line¶

dcmclient is one static binary exposing 60+ DICOM tools. Every tool follows the same contract, so an agent can chain them without bespoke glue. This skill maps tasks → tools and gives end-to-end recipes. It does not duplicate the tool reference — get exact argument schemas at runtime from dcmclient manifest (JSON, all tools) or dcmclient <tool> --help.

The calling contract (read once)¶

stdout = machine output, stderr = human diagnostics. Pass --json to status/network tools to get a {tool, ok, exit_code, result, error} envelope. Document tools (dcm2json, dcm2xml, dcmdump, dcmvalidate, dcm2content, dsrdump) write their structured artifact straight to stdout.
Branch on exit code, not stderr text: 0 ok · 1 runtime/input error (also covers tool-level rejections like an unknown enum string) · 104 bad numeric value · 105 rejected/mutually-exclusive option · 106 required option missing. Other parser codes exist (e.g. 109 unknown option); treat any non-zero as failure and read error from the --json envelope.
Network tools (search/wado/stow/forward, the *-scu) also surface the DICOM response status inside result.
Many subcommands have familiar short aliases: qido≡search, wado≡pull, stow≡push. Either name works.

Capability map (task → tool)¶

You need to…	Tool(s)
Search a PACS / DICOMweb	`search` (QIDO) · `find-scu` (C-FIND)
Pull studies	`wado` (WADO-RS) · `wado-uri` · `get-scu`/`move-scu` (C-GET/MOVE)
Push / route	`stow` (STOW-RS) · `store-scu` (C-STORE) · `forward` (web↔DIMSE)
Delete (DICOMweb)	`delete`
Run a receiver	`listen` · `store-scp`
Verify connectivity	`echo-scu`
Workflow / status SCUs (DIMSE-N)	`mpps-scu` · `ups-scu`/`ups` · `stgcmt-scu` · `ian-scu` · `print-scu` · `term-scu`
De-identify	`dcmdeident` (PS3.15 profiles)
Inspect metadata	`dcmdump` · `dcm2json` · `dcm2xml` · `dcmprobe`
Inspect semantics (SEG/RT/PS/SR auto-detect)	`dcm2content`
Render to image / video	`dcm2img` · `dcm2mpg`
Decode pixels for AI	`dcm2raw` (raw native ints) · `dcm2nii` (3-D NIfTI)
Edit tags	`dcmodify`
Transcode / change transfer syntax	`dcmconv`
Compare two objects	`dcmicmp`
Validate IOD conformance	`dcmvalidate`
Read SR documents	`dsrdump` · `dsr2html` · `dsr2xml`
Build / round-trip SR from text	`mksr` · `xml2dsr`
Build DICOM from JSON / XML / image / dump	`json2dcm` · `xml2dcm` · `img2dcm` · `dump2dcm`
Build a DICOMDIR (media interchange)	`dcmmkdir`
→ NIfTI / BIDS	`dcm2nii` · `seg2nii` (SEG→labelmap NIfTI)
→ NRRD / MetaImage (3D Slicer · ITK · nnU-Net)	`dcm2nrrd` · `dcm2mha` · `seg2nrrd` (SEG→named `.seg.nrrd`)
→ FHIR ImagingStudy	`dcm2fhir`
→ TIFF / WSI ↔ DICOM	`dcm2tiff` · `tiff2dcm`
Resample a volume	`dcmresample`
Radiomics features	`dcmradiomics`
RT dose-volume histogram	`dcmdvh`
Author SEG / paramap / SR / report / KOS	`mkseg` · `mkparamap` · `mksr` · `mkreport` · `mkkos`
Waveforms (ECG/EEG)	`dcm2waveform`
Digitally sign / verify	`dsign`
Encapsulate / extract PDF, STL, …	`dcmencap` · `dcmdecap` · `pdf2dcm` · `dcm2pdf`

The core loop (canonical recipe)¶

Each step is one tool call. Under MCP, issue the same calls as tools/call and read each JSON result to decide the next step.

# find the study (QIDO over DICOMweb)
dcmclient search --server https://pacs.example.com --patient-id 42 --modality CT --json
# pull it locally (WADO-RS)
dcmclient wado --server https://pacs.example.com --study 1.2.840.. -o ./study
# de-identify BEFORE anything downstream (see guardrails)
dcmclient dcmdeident ./study/*.dcm --out-dir ./deid
# build a 3-D NIfTI volume for a model
dcmclient dcm2nii ./deid ct.nii.gz

DIMSE variant: swap the first two steps for find-scu then get-scu/move-scu against a classic PACS — same downstream steps.

Deeper recipes by domain¶

Read the matching reference for multi-step recipes, real flags, and gotchas — load only the one the task needs.

When the task is…	Read
query / retrieve / store / route against a PACS or DICOMweb, or DIMSE-N workflow messaging	references/networking.md
feeding imaging into a model — volumes, NIfTI, raw pixels, resampling, radiomics	references/ai-prep.md
reading or authoring a semantic object — SEG, parametric map, RT plan/dose/DVH, SR, KOS	references/structured-objects.md
viewing pixels, transcoding (e.g. → JPH/HTJ2K), converting out (FHIR/TIFF/WSI/waveform), encapsulating, or signing	references/render-export.md

Guardrails (do not skip)¶

De-identify before egress. Run dcmdeident before sending data to any external service, FHIR endpoint, or third-party model API. Patient data leaves the building the moment you stow/forward/store-scu to a remote node.
Validate authored objects (dcmvalidate) before sending SEG/RT/SR/paramap back to a PACS — a malformed IOD can be silently rejected or corrupt a study.
Prefer --json for any step whose output feeds the next decision — parse the envelope, branch on ok/exit_code, don't scrape human text.
Network tools always need an explicit endpoint (--server for DICOMweb, AE/host/port for DIMSE). Never assume a default PACS.
WSI writing is TILED_FULL only; vendor SVS/NDPI are read-side concerns, not tiff2dcm inputs.

Going deeper¶

Exact argument schemas, examples, and read-only/network/writes-files flags for every tool: dcmclient manifest (full JSON registry) or dcmclient <tool> --help.
Wiring this as a live MCP server (Claude Desktop/Code, or any framework via the raw manifest): see the product's Agent integration doc.
A companion Python package covers the same imaging engine for agents that write Python instead of shelling out — use that surface when the task is "write Python", this one when the task is "run a command".