Manifest-based Access to DICOM Objects (MADO)
0.1.0 - trial-use

Manifest-based Access to DICOM Objects (MADO), published by IHE Radiology Technical Committee. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/RAD.MADO/ and changes regularly. See the Directory of published versions

## Imaging Manifest for DICOM Objects (MADO) Implementation Guide

Official URL: https://profiles.ihe.net/RAD/MADO/ImplementationGuide/ihe.rad.mado | Version: 0.1.0
Draft as of 2026-04-29 | Computable Name: IHE_RAD_MADO

This profile addresses the access to DICOM Instances based on an imaging study manifest. The need for this profile was identified as part of the sharing of imaging studies and related reports as required under the EHDS Regulation.

The access to DICOM Instances based on an imaging study manifest can be combined either with MHD (or MHDS) to deploy FHIR-based document sharing infrastructures or XDS.b, or some proprietary document sharing scheme. Such flexibility ensures a common and more effective way to access the DICOM Objects through a solid profiling of WADO-RS consistent with the XC-WADO Cross-Community profile and the IID (Invoke Image Display) profiles. The MADO Profile includes also a more robust imaging study manifest compared to the one introduced by XDS-I.b, supporting two complementary encodings based on the DICOM KOS IOD or FHIR Imaging Study resource, as well as profiling in a more precise way existing attributes and new attributes, such as those necessary to improve access to key images in a way compatible with the IHE KIN Profile.

> Note that this website only represents the FHIR part of the MADO specification. Where possible, references/redirects are added that point to the PDF MADO specification that contains the Volume 1, Volume 2 and the DICOM part of Volume 3.