How to View and Share DICOM Files in SharePoint

August 22, 2026 · Noam R

How to View and Share DICOM Files in SharePoint

Summary

A SharePoint folder can contain single DICOM files, entire multi-series studies, or indexed media packages. DICOM metadata defines the imaging hierarchy regardless of folder structures or file names.

This guide explains how to:

Prerequisite: Files are already uploaded to SharePoint and de-identified where required.

Non-goals

This guide does not cover:

How the DICOM hierarchy maps to SharePoint

The DICOM Standard organizes imaging data through metadata embedded inside each file rather than physical folder paths.

The DICOM hierarchy

Patient                 (The person receiving the scan)
└── Study               (The exam or imaging event)
    └── Series          (A specific sequence or scan group)
        └── Instance    (The DICOM file stored in SharePoint)
            └── Frame(s) (Image content inside the file)

DICOM levels and SharePoint storage

DICOM Level What It Means SharePoint Reality
Patient Subject of the scan Embedded file metadata
Study Examination event Embedded file metadata
Series Specific scan sequence Embedded file metadata
Instance Single DICOM object One file in SharePoint
Frame Image page(s) / slice(s) Stored inside the instance file; scroll to move between frames

How folders work in SharePoint

DICOM Viewer for SharePoint exposes Patient, Study, Series, and Instance navigation. Frames remain inside the active instance, where the mouse wheel moves between them.

DICOM Viewer for SharePoint with left-side Patient, Study, Series, and Instance navigation and right-side metadata annotated

One study with 43 single-frame instances across two series. DICOM Viewer for SharePoint groups Patient, Study, Series, and Instance navigation on the left. The right rail shows metadata for the active instance. Source: Vestibular-Schwannoma-MC-RC by Kujawa et al. (2023), CC BY 4.0. Cropped, redacted, and annotated by 1990Quebec.

The DICOM Part 10 specification defines how a single instance is stored in a file.

Common SharePoint file structures

The folder names below demonstrate layout patterns, but descriptive names are not required.

1. One instance in one file

Example Study/
└── IMG0001.dcm

The file contains one instance. That instance can hold a single frame or multiple frames. A multi-frame instance remains one file in SharePoint.

2. One series in several files

Example Study/
├── IMG0001.dcm
├── IMG0002.dcm
└── IMG0003.dcm

Each file stores one instance. When the series identifiers match, DICOM Viewer for SharePoint groups them into one series.

3. Several series and studies

Example Patient/
├── Study 1/
│   ├── Series 1/
│   │   ├── IMG0001.dcm
│   │   └── IMG0002.dcm
│   └── Series 2/
│       └── IMG0003.dcm
└── Study 2/
    └── Series 1/
        └── IMG0004.dcm

The same structure can also exist in a flat directory using system-generated filenames: 

Received Files/
├── 000001
├── 000002
├── 000003
└── 000004

As long as files contain study and series identifiers, DICOM Viewer for SharePoint reads the tags and reconstructs the hierarchy.

4. A DICOMDIR media package

A DICOMDIR file acts as an index for a DICOM media package. It points to the files that belong to the package and can include hierarchy records. It contains directory metadata, not image pixels. 

Received Media/
├── DICOMDIR
└── DICOM/
    ├── 0001/
    │   ├── 000001
    │   └── 000002
    └── 0002/
        └── 000001

DICOM Viewer for SharePoint supports packages with or without an index:

Choose what to open

Select a starting point and click View DICOM:

Selecting a DICOMDIR file or opening its parent folder yields the same result. A nested DICOMDIR does not replace the scope of a folder opened above it. Without a root-level DICOMDIR, folder scanning discovers files directly from file metadata.

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