Medical imaging systems handle your most sensitive health data, yet they’re becoming prime targets for cybercriminals.
Hackers infiltrated 93% of healthcare networks in 2023, exploiting vulnerabilities in systems that store everything from X-rays to MRI scans.
Modern attackers don’t just steal data—they disrupt patient care, demand ransoms, and sell medical records on dark web markets.
Understanding how they breach these systems, particularly through vulnerabilities in DICOM viewer library implementations and network protocols, is crucial for anyone working in healthcare technology.
The Real Ways Hackers Target Medical Systems
Healthcare organizations face attacks through multiple entry points. Ransomware incidents increased 278% in healthcare between 2022 and 2024, making medical facilities the most targeted industry.
Network-based attacks remain the most common. Hackers scan for exposed DICOM ports (typically 104 or 11112) that connect imaging devices.
When you leave these ports open to the internet, attackers can directly access your imaging network.
They exploit weak authentication protocols in older DICOM implementations, many of which still use default passwords or no authentication at all.
Phishing campaigns specifically target healthcare workers. Attackers send emails that appear to be legitimate vendor communications regarding imaging equipment updates.
When clicked, these install malware that spreads through your network, eventually reaching imaging systems.
Social engineering attacks have grown more sophisticated. Hackers research healthcare staff on social media, then call pretending to be IT support or equipment vendors.
They trick employees into providing network access credentials or installing remote access software.
DICOM Protocol Vulnerabilities Hackers Exploit
The DICOM (Digital Imaging and Communications in Medicine) protocol was designed for functionality, not security.
Most DICOM implementations lack basic encryption, transmitting images and patient data in plain text.
Legacy imaging equipment presents significant risks. Many hospitals still use systems from the early 2000s that can’t be updated with modern security patches.
These devices often run outdated operating systems with known vulnerabilities that hackers actively target.
Weak access controls in DICOM networks allow lateral movement. Once hackers breach one imaging device, they can often access others without additional authentication.
This happens because many networks treat all medical devices as trusted once connected.
Configuration errors create additional attack surfaces. IT teams sometimes expose DICOM services directly to the internet without proper firewall rules.
Security researchers found over 4,000 publicly accessible medical imaging systems in a 2024 scan of internet-connected devices.
| Attack Method | Success Rate | Average Impact |
| Ransomware | 67% | 23 days of downtime |
| Data breach | 45% | 2.3M records exposed |
| Network intrusion | 78% | 156 days undetected |
Advanced Defense Strategies That Actually Work
Network segmentation provides your most vigorous defense. You need to isolate imaging systems on separate VLANs with strict firewall rules.
This prevents hackers from accessing your general network and compromising medical devices.
Implement zero-trust architecture for all imaging equipment. Every device and user must authenticate before accessing DICOM data, regardless of network location.
This approach stops attackers who gain initial network access from freely exploring your systems.
Real-time monitoring helps detect intrusions early. Deploy network monitoring tools that understand DICOM traffic patterns.
Unusual data transfers, unexpected device communications, or access attempts from unknown IP addresses should trigger immediate alerts.
Regular vulnerability assessments are non-negotiable. Scan your imaging network monthly for new security holes.
Many healthcare organizations only discover breaches months after they occur because they lack continuous monitoring.
Update your incident response procedures specifically for imaging systems. You need plans that account for the critical nature of medical equipment—shutting down compromised systems could impact patient care.
Practice scenarios that require maintaining operations while containing threats.
Protecting Your DICOM Data Infrastructure
Encryption must cover data at rest and in transit. Modern DICOM implementations support TLS encryption; however, you must enable and properly configure it. Many systems ship with encryption disabled by default.
Access control improvements require both technical and procedural changes. Implement role-based permissions that restrict access to imaging data, limiting who can view, modify, or export it.
Require multi-factor authentication for all system access, especially for administrative accounts.
Backup strategies for medical imaging differ from standard IT backups. DICOM files are large and must remain accessible for years due to regulatory requirements.
You need offline backup copies that ransomware can’t encrypt, plus rapid recovery procedures that minimize disruptions to patient care.
Regular security training specifically for healthcare staff makes a measurable difference.
Organizations with comprehensive security awareness programs experience 70% fewer successful phishing attacks—train staff to recognize healthcare-specific social engineering tactics and report suspicious communications.
Consider managed security services specifically designed for the healthcare industry. Many hospitals lack the specialized expertise needed to secure complex medical networks.
Third-party security providers can offer 24/7 monitoring and response capabilities that internal IT teams often can’t match.
The threat landscape for medical imaging systems continues evolving rapidly.
Hackers develop new techniques faster than many healthcare organizations can adapt their defenses.
But with proper network segmentation, continuous monitoring, and staff training, you can significantly reduce your risk profile and protect the sensitive medical data your patients trust you to secure.
