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What This Guide Helps With
Troubleshooting failed image exports to PACS, DICOM send errors, or studies not appearing in the imaging system.
Step-by-Step Troubleshooting
Ensure Patient Safety First
- Do not troubleshoot during an active exam.
- If needed, complete or safely stop the study and move the patient to another system.
Expected: Prevents data loss and ensures patient care is not disrupted.
Why it matters: Prevents data loss and ensures patient care is not disrupted.
Verify the Reported Issue
- Attempt to send a study to PACS.
- Observe for:
- Error messages
- Failed send notifications
- Studies stuck in queue
Expected: Export fails or does not complete.
Why it matters: Confirms this is a reproducible DICOM communication issue.
Check Network Connectivity
- Verify the system is connected to the network:
- Check Ethernet cable is securely connected
- Confirm network link lights are active
- Attempt to ping PACS server (if accessible)
Expected: Stable network connection.
Why it matters: Loss of network is the most common cause of DICOM failures.
Confirm DICOM Node Configuration
- Review DICOM settings:
- AE Title (local and remote)
- IP address of PACS server
- Port number
- Ensure all values match the PACS configuration.
Expected: Correct and matching DICOM settings.
Why it matters: Even small mismatches prevent successful communication.
Verify DICOM Association (Echo Test)
- Perform a DICOM Echo/Test (if available in system settings).
Expected: Successful verification/echo response.
Why it matters: Confirms communication between ultrasound system and PACS server.
Check Export Queue / Storage Capacity
- Review system storage:
- Check if studies are queued but not sending
- Verify local storage is not full
- Clear completed or unnecessary studies if needed.
Expected: Queue processes normally and storage has space.
Why it matters: Full storage or stuck queues can block exports.
Validate Study Data and Patient Information
- Open the study and confirm:
- Patient ID and demographics are complete
- No invalid characters or missing required fields
Expected: Clean, complete study data.
Why it matters: Invalid data fields can cause DICOM rejection by PACS.
Check PACS Availability
- Confirm with IT or PACS team:
- PACS server is online
- No downtime or maintenance
- No recent configuration changes
Expected: PACS system is operational.
Why it matters: Issue may be external to the ultrasound system.
Restart System and Retry Export
- Reboot the ultrasound system and attempt to resend the study.
Expected: Export completes successfully after restart.
Why it matters: Clears temporary communication or software faults.
If the Problem Persists
If all external causes (network, configuration, PACS availability, and storage) have been ruled out, the issue is likely internal to the system software or communication module.
Remove the system from service if critical workflow is impacted. Label the device Out of Service and escalate for vendor support or advanced diagnostics.
Clinical Use Tip
Always ensure studies are successfully sent and verified in PACS before deleting them locally. Never troubleshoot DICOM issues during an active patient exam.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Ultrasound system unable to send studies to PACS; exams not appearing in imaging system."
Cause
What was observed during troubleshooting.
Example:
"Incorrect DICOM AE Title configuration preventing successful association with PACS server."
Resolution
What action was taken.
Example:
"Corrected DICOM configuration settings and verified successful export using echo test and study transmission."
Helpful Details to Include (If Known)
- Network connection verified
- DICOM echo test result
- Error messages displayed
- Export queue status
- Storage capacity checked
- PACS system status confirmed
- Final export success or failure
Final Thought
DICOM export failures are most often caused by configuration or network issues, not internal hardware faults. A structured approach—starting with connectivity and settings—ensures safe, efficient resolution. Escalation is appropriate once external causes are eliminated, reinforcing the value of disciplined troubleshooting and clear documentation.
That is successful troubleshooting.