CVE-2019-11687: An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through 2019b and continuing in current implementations. The ...

Description

An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through 2019b and continuing in current implementations. The 128-byte preamble of a DICOM file that complies with this specification can contain arbitrary executable headers for multiple operating systems, including Portable Executable (PE) files for Windows and Executable and Linkable Format (ELF) files for Linux-based systems. This space is left unspecified so that dual-purpose files can be created. For example, dual-purpose TIFF/DICOM files are used in digital whole slide imaging applications in medicine. This design flaw enables system-wide compromise as malicious DICOM files are routinely shared between medical devices and hospital systems and transported via removable media for patient care coordination. To exploit this vulnerability, someone must execute the maliciously crafted file. These files can be executable even with the .dcm file extension. Anti-malware configurations at healthcare facilities often ignore medical imagery. DICOM files exist on systems that process protected health information, and successful exploitation could result in violations of regulatory compliance requirements such as HIPAA and FDA postmarket obligations.

Metrics

CVSS 3.1

7.8/10

CVSS:3.1/AV:L/AC:L/PR:N/UI:R/S:U/C:H/I:H/A:H

EPSS Probability

2.75%

84.3th percentile

Probability of exploitation in the next 30 days. Learn more

Weakness Enumeration

Affected Software

Vendor	Product	Versions
Nema	Dicom Standard	>= 1995, <= 2019b

References

http://www.securityfocus.com/bid/108730
https://github.com/d00rt/pedicomExploit, Third Party Advisory
https://github.com/d00rt/pedicom/blob/master/doc/Attacking_Digital_Imaging_and_Communication_in_Medicine_%28DICOM%29_file_format_standard_-_Markel_Picado_Ortiz_%28d00rt%29.pdf
https://labs.cylera.com/2019.04.16/pe-dicom-medical-malwareExploit, Technical Description, Third Party Advisory
https://www.praetorian.com/blog/elfdicom-poc-malware-polyglot-exploiting-linux-based-medical-devices/
http://www.securityfocus.com/bid/108730
https://github.com/d00rt/pedicomExploit, Third Party Advisory
https://github.com/d00rt/pedicom/blob/master/doc/Attacking_Digital_Imaging_and_Communication_in_Medicine_%28DICOM%29_file_format_standard_-_Markel_Picado_Ortiz_%28d00rt%29.pdf
https://labs.cylera.com/2019.04.16/pe-dicom-medical-malwareExploit, Technical Description, Third Party Advisory

Timeline

Published: May 2, 2019
Last Modified: Jun 17, 2026
Status: Modified

Frequently Asked Questions

What is CVE-2019-11687?

An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through 2019b and continuing in current implementations. The 128-byte preamble of a DICOM file that complies with this specification can contain arbitrary executable headers for multiple operating systems, including Portable Executable (PE) files for Windows and Executable and Linkable Format (ELF) files for Linux-based systems. This space is left unspecified so that dual-purpose files can be created. For example, dual-purpose TIFF/DICOM files are used in digital whole slide imaging applications in medicine. This design flaw enables system-wide compromise as malicious DICOM files are routinely shared between medical devices and hospital systems and transported via removable media for patient care coordination. To exploit this vulnerability, someone must execute the maliciously crafted file. These files can be executable even with the .dcm file extension. Anti-malware configurations at healthcare facilities often ignore medical imagery. DICOM files exist on systems that process protected health information, and successful exploitation could result in violations of regulatory compliance requirements such as HIPAA and FDA postmarket obligations.

How severe is CVE-2019-11687?

CVE-2019-11687 has a CVSS score of 7.8/10 (HIGH severity). The EPSS model estimates a 2.75% probability of exploitation in the next 30 days.

How do I fix CVE-2019-11687?

Check the vendor references and advisories linked above for patched versions and mitigation guidance. You can also run a Strix scan to test if your systems are affected.