How to guarantee study transfer atomicity?


There are multiple ways to transfer studies to an Orthanc instance. Only a few of them provide a guarantee that the study has been transferred completely.


  • By transfer atomicity, we mean the capability to transfer only full studies and make sure that if a transfer fails before it is complete, no partial data is saved in Orthanc. The study is either fully stored or not stored at all.
  • DICOM, in general, does not provide any way to detect that a study is complete. Actually, a study is never complete since, e.g, a viewing workstation or an AI algorithm can still add a new enhanced series even years after the study has been acquired. However, it is still important, in many applications, to make sure that a study, in its current state, is fully transmitted to another destination.
  • Both the client/source and the server/destination might be interrested in the transfer status. Usually, the client will have a guarantee that the study was fully transmitted if it receives a successful answer from the server. On the server side, it is usually more complex to make sure that the full study has been received.


Transfer method What can the Client/source trust to make sure the full study has been stored in the server ? Can Server/destination trust StableStudy event to consider the study as complete ?
  • If every C-Store receives a success status.
  • If /modalities/sample/store receives a 200 or if job is successfull
C-Store with storage commitment
  • same as above
  • use storage commitment to check which instances are stored on destination
  • If client receives a 200
  • If /dicom-web/servers/sample/stow returns a 200 or if job is successfull
Orthanc Rest API
  • If every call to /instances receives a 200
  • If /peers/sample/store receives a 200 or if job is successfull
Transfers accelerator plugin
  • If /transfers/send receives a 200 or if job is successfull
Yes (provided that the client sends full study)


If you are sending a study to Orthanc via C-Store, the study will be considered as stable after a given period of time (defined by the configuration StableAge). This gives no guarantee at all that the study has been fully transferred. The sending modality may have paused transfer for a while and might resume in a few minutes.

Although inaccurate by design, the IsStable status in Orthanc is the best way to assume that a study has been fully transferred via DICOM. The default value of 60 seconds is appropriate for most setups.


  • When Orthanc, acting as C-Store SCP, responds with a success status to a C-Store command, it means that the instance has already been saved in the DB and on the storage.

C-Store with storage commitment

Since release 1.6.0, Orthanc supports Storage Commitment. Storage commitment is not a guarantee of atomicity but simply provides a way to check that a set of instances have really been saved by Orthanc.

Given that Orthanc only responsds to C-Store with a success status once the instance has really been saved in DB and on disk, storage commitment actually do not provide any additional guarantee during transfer.

DicomWeb STOW-RS

STOW-RS can be used to transfer studies to an Orthanc. The STOW-RS request contains a list of DICOM instances to store in the destination Orthanc (likely a complete study).

Files are stored as they are received which means that, if the transfer is interrupted, only a partial study may be stored on the destination. Therefore, on the destination, a StableStudy event might be triggered even if the study was not fully received.


  • In earlier Orthanc versions, ChunkedTransfers was disabled, and the whole study was transmitted in a single HTTP request and parsed only once the full HTTP request had been received. Therefore, the whole study was stored at once on the destination. However, note that ChunkedTransfers is enabled by default on every Orthanc server but it can be disabled in the client configuration. Also note that studies bigger than 2 GB can not be transferred with ChunkedTransfers disabled which means it is not recommended to perform transfers with disabled ChunkedTransfers.

Orthanc Rest API

When transferring a study through the Orthanc Rest API, each instance is transferred individually. Therefore, on server side, if the transfer is interrupted, the destination has no way to know that the study has been fully transmitted or not.

The server will respond with a 200 HTTP status only once the instance is stored in DB and on storage.

Transfers Accelerator plugin

Transfers Accelerator plugin has been design to:

  • speed up transfers over HTTP/HTTPS.
  • guarantee the transfer atomicity

Provided that the client is sending a full study, the server receiving it will store it completely. Therefore, on server side, the StableStudy event will trigger only on full studies.