A side-by-side look at PACS capabilities, from supported modalities and interoperability standards to pricing, licensing, and EHR integration.
Picture archiving and communication systems (PACS) are central to how imaging data is stored, viewed, and shared across healthcare organizations. As pricing models, supported modalities, viewer types, interoperability standards, and integration with EHRs and VNAs can all vary—as can update cycles, advanced tools, and support options—this comparison guide pulls those details together to help HTM and imaging leaders understand how today’s PACS offerings compare and what features each platform brings to the table.
Philips – Philips Image Management 15
Konica Minolta Healthcare Americas – EXA
Optum – Stratus Imaging PACS
Merge by Merative – Merge PACS
RamSoft Inc – OmegaAI
Intelerad – IntelePACS
Siemens Healthineers – Syngo Carbon
| Company Name: | Philips | Konica Minolta Healthcare Americas | Optum | Merge by Merative | RamSoft Inc | RamSoft Inc | Intelerad | AGFA Healthcare | Siemens Healthineers |
|---|---|---|---|---|---|---|---|---|---|
| PACS: | Philips Image Management 15 | EXA | Stratus Imaging PACS | Merge PACS | OmegaAI | PowerServer 6.7 | IntelePACS | AGFA Healthcare Enterprise Imaging | Syngo Carbon |
| Website: | usa.philips.com/healthcare/technology/web-diagnostic-viewer | healthcare.konicaminolta.us/exa-pacsris | business.optum.com/en/operations-technology/enterprise-imaging/stratus/change-healthcare-stratus-imaging-pacs.html | merative.com/merge-imaging/pacs | ramsoft.com/products/omegaai | ramsoft.com/products/powerserver | intelerad.com | agfahealthcare.com/ | siemens-healthineers.com/en-us/digital-health-solutions/syngo-carbon |
| Description: | Philips Image Management is a modular, web-based enterprise platform that unifies capture, storage, access, and collaboration for clinical imaging and data across radiology, cardiology, and other specialties. It consolidates images and records into a vendor-neutral archive and delivers zero-footprint diagnostic viewing, secure enterprise sharing, workflow orchestration, and analytics. | Exa PACS unifies RIS and PACS on a single database, uses server-side rendering with a diagnostic zero-footprint viewer for fast reading on any device, keeps PHI off workstations for stronger security, and offers flexible, site-specific workflow design through on premise, private and public cloud implementations. All supported by our world-class rated customer service team. | Stratus Imaging PACS from Optum is a next-generation, cloud-native solution built on the Google Cloud Platform (GCP) to deliver a true SaaS experience, no VPNs or hardware hassles. Designed for speed, simplicity, and scalability, Stratus Imaging PACS transforms the radiology workflow from image acquisition to final report. | Merge PACS is a standards-based medical imaging diagnostic workstation that serves as an adjunct to assist the clinician to view, read, and report their findings. Merge PACS processes and displays medical images from DICOM-compliant modalities. The device is designed to enable efficient workflows by maintaining clinicians’ worklists and retrieving and managing studies for reading, reporting, communication, and storage. | Comparison Guide (24×7) PACS – Google Forms OmegaAI is a cloud-native PACS with a unified viewer, reporting, and VNA. Its GPU- accelerated rendering, AI-powered workflow automation, and zero-footprint design enable fast diagnostics anywhere. Multi-site support and scalable cloud storage reduces cost and complexity. | Comparison Guide (24×7) PACS – Google Forms PowerServer is a cloud hybrid solution that delivers an integrated PACS/RIS with strong workflow automation, modality worklist, reporting, and advanced viewing capabilities. Its flexible configuration, broad modality support, and proven stability make it ideal for busy radiology groups and multi-facility sites. | IntelePACS is a cloud-based platform built with radiologists in mind, unifying worklist, viewer, and reporting into one solution. IntelePACS® streamlines workflows, accelerates diagnostic turnaround, and integrates systems into a single access point. Built to scale, support AI tools, and deliver secure high-performance infrastructure. | The platform keeps work moving seamlessly across specialties, sites, and systems. With advanced, native diagnostic imaging features combined with intelligent workflow orchestration, AGFA EI supports efficient and accurate image interpretation keeping diagnosticians in the flow and helps them deliver excellent patient care. Additionally, AGFA EI provides frictionless access to imaging data by seamlessly embedding into EHR systems. | Syngo Carbon differentiates itself in the radiology PACS market through a unified, platform-centric architecture designed for enterprise imaging. Unlike traditional PACS built from loosely connected modules, Syngo Carbon is a single cohesive platform with a shared data model, consistent user experience, and vendor-neutral data management. |
| Last Major Update: | 15.1.0 introduced the new web diagnostic viewer and other features. It can be delivered on-premise or through the Philips HealthSuite Imaging Cloud powered by AWS. | Summer 2025. EXA Version 34.1.0 included: Amazon AHI support, external API platform, identity and access management, EXA Teleradiology, EXA Enterprise, EXA advanced visualization, improved digital faxing, billing, and patient self-scheduling partner integrations | The next version of Stratus Imaging PACS will be generally available in spring 2026. This is a redesigned end-to-end cloud-native platform with new AI-powered clinical reporting integrated into an intelligent worklist and unified viewer. Unlike legacy systems, it minimizes total cost of ownership by reducing licensing and integration, while also simplifying IT management for organizations with limited technical staff. | September 2025, Merge PACS 9.4. Healthcare providers can expect to take advantage of an upgraded on-premise or cloud-based PACS in their workstations with enhanced diagnostic workflows, new collaboration functionality, refreshed and more efficient worklists, and heightened cybersecurity features. New capabilities support additional efficiencies in mammography reading and academic and teaching use cases. | Q4 2025, adding performance upgrades, enhanced image viewer tools, and a new worklist experience. | November 2025. Version 6.7 introduces security hardening, support for the latest lossless image compression and rendering, improved performance, SSO, and MFA support. | October 2025. This update introduced several enhancements focused on radiologist workflow, study visibility, and patient communication. Added a floating thumbnail panel to help radiologists navigate studies more effectively during reads. A grouped/linked procedures banner now alerts users to related unseen studies and automatically clears once reviewed. Patient matching was enhanced to surface potential matches based on confidence thresholds. | Receives a major update every nine to 18 months, with one major update in 2025 and two major updates planned for 2026. | Updated quarterly. The most recent update introduced an additional smart Reporting tool, offering more robust and flexible reporting options. Improved reading flows further optimize the process of reviewing and interpreting patient data, and enhanced workflow tools are now available, granting users greater access to patient information directly within the reading user interface. |
| Supported Modalities: | CT, MRI, X-ray/DR/CR, Ultrasound, Mammography, PET/CT, nuclear medicine, ECG waveforms, non-DICOM images and videos | CT, MRI, X-Ray/DR/CR, Ultrasound, Mammography, PET/CT, Nuclear Medicine | CT, MRI, X-Ray/DR/CR, Ultrasound, Mammography, PET/CT, Nuclear Medicine | CT, MRI, X-Ray/DR/CR, Ultrasound, Mammography, PET/CT, Nuclear Medicine, BTO, DX, XA, RF, SC, PR, SR, other DICOM-compliant modalities | CT, MRI, X-Ray/DR/CR, Ultrasound, Mammography, PET/CT, Nuclear Medicine, all DICOM-supported modalities | CT, MRI, X-Ray/DR/CR, Ultrasound, Mammography, PET/CT, Nuclear Medicine, all DICOM-supported modalities | CT, MRI, X-Ray/DR/CR, Ultrasound, Mammography, PET/CT, Nuclear Medicine, Fluroscopy, Endoscopy, ECG | CT, MRI, X-Ray/DR/CR, Ultrasound, Mammography, PET/CT, Nuclear Medicine, POCUS, Pathology, Endoscopy, other medical imaging departments | CT, MRI, X-Ray/DR/CR, Ultrasound, Mammography, PET/CT, Nuclear Medicine |
| Primary Interoperability Standards Supported: | DICOM, DICOMweb, HL7, FHIR, IHE Profiles | DICOM, DICOMweb, HL7, FHIR, IHE Profiles | DICOM, HL7, IHE Profiles, Healthcare API | DICOM, DICOMweb, HL7, IHE Profiles | DICOM, DICOMweb, HL7, FHIR, IHE Profiles | DICOM, DICOMweb, HL7, FHIR, IHE Profiles | DICOM, DICOMweb, HL7, FHIR | DICOM, DICOMweb, HL7, FHIR, IHE Profiles | DICOM, DICOMweb, HL7, FHIR, IHE Profiles, non-DICOM data in orginal format |
| Viewer Type: | Zero-footprint viewer, web-based viewer, diagnostic workstation viewer, mobile/tablet viewer | Zero-footprint viewer, web-based viewer, mobile/tablet viewer | Zero-footprint viewer, web-based viewer, diagnostic workstation viewer | Diagnostic workstation viewer | Zero-footprint viewer, web-based viewer, diagnostic workstation viewer, mobile/tablet viewer | Zero-footprint viewer, web-based viewer, diagnostic workstation viewer | Zero-footprint viewer, web-based viewer, diagnostic workstation viewer | Zero-footprint viewer, web-based viewer, diagnostic workstation viewer, mobile/tablet viewer, Pixel-streaming client | Zero-footprint viewer, web-based viewer, diagnostic workstation viewer, mobile/tablet viewer (not for diagnostic use) |
| Does It Include Integrated Reporting: | Yes, built in | Available as an add-on module | Yes, built in | Requires third-party reporting solution | Yes, built in | Yes, built in, available as an add-on module | Requires third-party reporting solution | Yes, built in | Yes, built in |
| Advanced Tools Included: | The zero-footprint web diagnostic viewer supports hanging protocols, MPR, real-time 3D, volume matching, synchronized scrolling, DICOM and non-DICOM comparison, search and bookmarks, lesion management, digital subtraction, perfusion, diffusion, and cardiac/vessel analysis. It supports CT/MR/PET-CT via Philips Advanced Visualization and Magic Glass for Spectral CT, breast imaging with a dedicated mammography keypad, collaboration tools, interactive reporting, and integration with Philips AI Manager and third-party apps. | 3D/MPR, Mammo, Hanging Protocols, AI platform integration, PET, Multi-Facility Support, Chat, Peer Review | Includes native 3D/MPR, CT/PET fusion, and 3D segmentation algorithms across CT, MR, and PET, with AI-driven enhancements such as spine labeling and long bone measurements. AI-based display protocols ensure consistent image presentation across modalities and vendors. For mammography, the PACS provides BI-RADS support, interactive overlays, 2D/3D switching, and chronological stacking of prior CC and MLO views for efficient comparison. | Linking, MPR, MIP, 3D image, fusion/ registration of CT, MR, and PET; as well as CVR (Color Volume Rendering), measurements (linear distances, angles, areas, SUV, etc), and annotations (for example, outline and label regions of interest, label spinal vertebrae). | Supports 3D/MPR with MIP, AveIP, MinIP, oblique tools, slab control, and PET-CT fusion with color maps, plus cine playback and configurable hanging protocols. Mammography tools support FFDM and DBT, magnification, flip/rotate, quad zoom, 1:1 pixel view, synchronized viewing, ROI measurement, and presentation states. Additional features include structured report viewing, workflow design, modality and universal worklists with HL7-FHIR integration, VNA archiving, window/level presets, study comparison, multi-monitor layouts, key image support, and image quality control tools. | Supports 3D/MPR for CT and MR, cine playback for ultrasound and multi-frame studies, and customizable hanging protocols. Mammography tools include FFDM viewing, 1:1 pixel view, magnification, annotations, and synchronized viewing. Additional features include advanced measurement tools, presentation states, study comparison, multi-monitor workspace layouts, structured reporting/DICOM SR viewing, prefetch and auto-routing rules, modality worklist and HL7-driven workflow automation, and VNA support for multi-modality archiving. | 3D/MPR, hanging protocols, AI tools, mammo tools, Image Fusion, Real Time Screen Sharing aka Study Collaboration, Intelligent workflow distribution, and AI enabled triaging. | 3D/MPR, hanging protocols, AI tools, mammo tools, Lesion tracking, Vessel Analysis, and other advance tools | Advanced presentation includes 2D, MPR and MPR fusion, MIP/MinIP, VRT and cinematic VRT, plus image evaluation and processing. MR tools include calculation, filtering, 2D/3D distortion correction, ADC and b-value calculation, and composing, with auto windowing. Vessel tools include automatic heart and coronary tree isolation, segmentation, curved views, and CT/MR vessel evaluation. ALPHA automates and standardizes reconstructions, with access to Syngo Carbon AV advanced applications and workflows. Supports PACS hanging protocols plus configurable reading/reporting flows, structured reading layouts, and parked views. |
| Supported EHR Integrations: | Epic, Cerner/Oracle Health, Meditech, Allscripts, most global EMR/EHR | Epic, EXA RIS is part of EXA Platform | Epic, Cerner/Oracle Health, Meditech, Allscripts | Epic, Cerner/Oracle Health, Meditech | All supported, if HL7 or FHIR are available from the third party | All supported, if HL7 or FHIR are available from the third party | Epic, Cerner/Oracle Health, Meditech, Allscripts, integrations with over 65 EMRs/RIS | Epic, Cerner/Oracle Health, Meditech, Allscripts | Epic, Cerner/Oracle Health, Meditech, Allscripts, all EMR that supports IHE profiles |
| VNA Compatibility: | Native VNA | Compatible with third-party VNAs | Native VNA, Compatible with third-party VNAs | Native VNA, Compatible with third-party VNAs | Native VNA, Compatible with third-party VNAs | Native VNA, Compatible with third-party VNAs | Native VNA, Compatible with third-party VNAs | Native VNA | Native VNA, Compatible with third-party VNAs |
| Licensing Model: | Perpetual license, subscription, enterprise license, per exam | Perpetual license, subscription, per exam | Subscription | Perpetual license, subscription | Subscription, per study | Licensing per exam, subscription | Per exam | Subscription, per exam, term use CAPEX licensing | Perpetual license, subscription, enterprise, license per exam |
| Pricing: | Not provided | Not provided | Varies based on needs and configurations. | Varies. Contact company for info. | Starting at $500 per month | Starting at $500 per month | Contact company for info. | Varies based on needs and configurations | Varies. Contact company for info. |
Last updated January 2026.
Information for this guide is based on data submitted by PACS marketers. 24×7 strives for accuracy in all data but cannot be held responsible for claims made by marketers. All PACS marketers get one listing at no charge. Advertisers are offered multiple listings. All PACS may not be included. Email [email protected] to be considered for the next update.
