I think some of the frustration towards DICOM is misattributed. Yes, there are many instances of the standard being implemented poorly, and yes it is not always

I think some of the frustration towards DICOM is misattributed. Yes, there are many instances of the standard being implemented poorly, and yes it is not always the most convenient having to index into your metadata using hex digits. But at least there IS a well documented, universally adopted standard that captures the most important information relevant to medical images right there next to the pixels. If this weren't the case, I think it would be much harder to have reliable interoperability between the highly complex + diverse types of systems that need to talk to each other in order to conduct an imaging workflow. There is a reason it exists and is so widely adopted -- and if you dig in to the details, a lot of thought has been put into its design. I highly recommend the book https://www.amazon.com/Digital-Imaging-Communications-Medicine-DICOM/dp/3642108490 https://www.amazon.com/Digital-Imaging-Communications-Medici..., which believe it or not is a very entertaining read on the subject.