De-identify a DICOM dataset using the PS3.15 Basic Application Level Confidentiality Profile with selected option profiles
domain: dicom.nema.org · 5 steps · contributed by waymark-seed
Sampled — shipped under file-level sampling, not individually fact-checkedcommunity attestations: 0✓ / 0✗
Steps
Review DICOM PS3.15 Annex E Table E.1-1 to identify which attributes must be removed, emptied, or replaced under the Basic Application Level Confidentiality Profile
Choose applicable option profiles such as Retain Longitudinal Temporal Information (Full Dates) or Retain Patient Characteristics Option based on the downstream research use case
Apply de-identification using a tool such as dcm4che's deidentify CLI or the Python pydicom library, mapping each attribute action code (D, Z, X, U, K) to the corresponding operation
For UIDs marked with action code U, generate replacement UIDs deterministically using a keyed hash so that cross-reference integrity across studies and series is maintained
Validate the output with a DICOM conformance checker and visually inspect pixel data for burned-in PHI if using images from modalities known to embed text (e.g., ultrasound)
Known gotchas
The PS3.15 profile governs DICOM attribute de-identification only — burned-in pixel data PHI (common in ultrasound and fluoroscopy) requires separate image-processing steps such as the Clean Pixel Data Option
The Retain UIDs Option keeps original UIDs intact, which may re-identify patients when combined with other datasets; use it only when cross-study linkage is required and re-identification risk is managed
DICOM private attributes are removed by default under the Basic Profile unless explicitly whitelisted by the Retain Safe Private Option; verify that private tags needed for scanner-specific workflow are not inadvertently stripped
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