criticalOther

OFFIS DCMTK Toolkit Multiple Vulnerabilities (Path Traversal, Memory Exhaustion, Type Confusion)

First seen Jul 5, 2026 · Updated Jul 5, 2026 · CVSS 9.8

ICSmedical-devicesDICOMpath-traversaldenial-of-servicehealthcareCISA-advisory

OFFIS DCMTK Toolkit versions <=3.7.0 contain five vulnerabilities including a critical path traversal flaw (CVSS 9.8) allowing malicious DICOM servers to write arbitrary files on clients, plus multiple unauthenticated memory-exhaustion and type-confusion bugs that can crash storescp and worklist server processes. These affect healthcare imaging infrastructure worldwide and could enable file write outside intended directories, cross-department data disclosure, or denial of service against clinical DICOM services. No public exploitation has been reported to CISA as of the advisory date.

Technical Analysis

CVE-2026-50003 (CVSS 9.8) is a path traversal in DCMTK's bit-preserving C-GET storage mode, allowing a malicious/compromised DICOM server to write files outside the configured output directory via relative or absolute paths (CWE-22). CVE-2026-50254 and CVE-2026-35505 (CVSS 7.5 each) are unauthenticated memory-leak DoS conditions (CWE-401) in storescp and related network handling, where repeated crafted connections exhaust memory in single-process deployments until the service is killed. CVE-2026-52868 (CVSS 8.2) is a separate path traversal allowing unauthenticated reads of worklist records outside the per-AE storage area, potentially crossing departmental/clinic data boundaries. CVE-2026-44628 (CVSS 7.5) is a type confusion (CWE-843) that crashes the worklist server via a single crafted query under specific configuration conditions. These vulnerabilities primarily threaten healthcare PACS/DICOM infrastructure rather than AI agent frameworks directly, though any AI-driven medical imaging or RAG pipeline that ingests DICOM data via DCMTK-based services could be exposed to file-write, data-leakage, or availability impacts if such agents rely on vulnerable DCMTK components for image intake or processing.

Affected Systems

OFFIS DCMTK Toolkit versions <=3.7.0, including storescp (C-STORE SCP) and worklist server (wlmscpfs) components used in DICOM-based medical imaging systems worldwide.

Indicators of Compromise

  • No specific IOCs published; no known public exploitation reported to CISA at time of advisory.

Remediation Steps

  1. 1

    Update DCMTK

    Upgrade to the latest DCMTK release/snapshot from https://github.com/DCMTK/dcmtk/releases/tag/latest, which contains vendor fixes for all five CVEs.

  2. 2

    Network segmentation

    Isolate DICOM/PACS systems and control system networks behind firewalls; ensure they are not directly accessible from the internet.

  3. 3

    Restrict remote access

    Use VPNs or other secured remote access mechanisms when remote connectivity to DCMTK-based services is required, keeping VPN software updated.

  4. 4

    Monitor and harden storage directories

    Verify file system permissions and per-AE worklist directory isolation to reduce impact of path traversal exploitation, and monitor for unexpected file writes.

  5. 5

    Service resiliency

    Deploy process monitoring/auto-restart and consider multi-process deployment modes for storescp to reduce impact of memory-exhaustion DoS attacks.

CVE / Advisory IDs

CVE-2026-50003CVE-2026-50254CVE-2026-35505CVE-2026-52868CVE-2026-44628

Industries Most Exposed

Healthcare and Public HealthMedical ImagingCritical Infrastructure

Sources

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