OpenREM is a free, open-source web application for monitoring patient radiation dose, built for medical physicists and radiation protection staff. It collects dose data from X-ray equipment, stores it in a database and shows it in a browser with filters, charts and spreadsheet exports, so you can compare exposures between rooms, protocols and time periods. It began at The Royal Marsden NHS Foundation Trust in the UK and is written in Python with Django.
OpenREM is a server application, not a desktop viewer. The current stable release is still 0.10.0 (November 2019). Development continues on version 1.0, whose third beta (1.0.0b3) was published in February 2026 and which the documentation already describes in full. Dental relevance is indirect: OpenREM is built for general radiology, but the 1.0 series can import panoramic (PX) exams, which then appear in its radiographic section.
OpenREM at a glance
| Item | Details |
|---|---|
| Latest version | 0.10.0 stable (8 November 2019); 1.0.0b3 beta (February 2026) |
| Licence | Free and open source, GPLv3 (with additional permissions) |
| Platforms | Server software: Docker (Linux containers), native Linux, or native Windows Server; used through a web browser |
| Developer | OpenREM project; initial author Ed McDonagh, The Royal Marsden NHS Foundation Trust |
| Official website | openrem.org (documentation at docs.openrem.org) |
| Best for | Medical physics and radiation protection teams auditing dose across several X-ray rooms or sites |
What it does
- Imports dose data from DICOM Radiation Dose Structured Reports (RDSR), DICOM image headers and other sources. Files can be loaded locally, sent directly from modalities, or pulled by query-retrieve from a PACS.
- Covers CT, planar radiography, fluoroscopy, mammography and, in the 1.0 series, nuclear medicine.
- Offers a web interface for filtering and searching studies, with a detail view per study and a home page summarising recent activity.
- Provides modality-specific charts: dose per protocol, histograms and workload over time.
- Uses “standard name mapping” to group differently named protocols from different machines, so you can compare like with like.
- Exports to CSV and XLSX for further analysis by a medical physicist.
- Calculates skin dose maps for fluoroscopy and sends high-dose alerts for fluoroscopy.
- Excludes patient-identifiable data by default. Names and IDs can optionally be stored as hashes.
How dental teams use it
OpenREM has no dental-specific module, and its documentation does not mention intraoral or dental CBCT units. Where it can help is in larger dental hospitals, dental schools or groups whose radiation protection adviser or medical physicist already runs OpenREM for general radiology.
Adding panoramic units to an existing OpenREM server
- Check with the equipment vendor whether the panoramic unit or its imaging software can send DICOM images or dose reports to a DICOM destination.
- Configure the unit (or the practice PACS) to send to the OpenREM DICOM store node, or let OpenREM query-retrieve the studies from the PACS.
- In the 1.0 series, PX exams are imported into the Radiographic section. Use the charts there to compare exposures between units and over time.
- Export the data to XLSX for the physicist’s periodic dose audit.
Checking whether a CBCT unit can be monitored
For CBCT, the outcome depends on what dose information the unit writes into its DICOM output (an RDSR or dose fields in the image headers). Send a sample study to a test OpenREM instance and see what gets extracted before planning a rollout.
Install and first run
Docker (recommended for 1.0): the documentation calls this the quickest way to get a complete OpenREM instance, including the database, web server and DICOM server, on any system that runs Linux containers. That includes Windows 10 with Docker Desktop, but not Windows Server at present.
Native Linux: install Python, a web server (e.g. Nginx), a database (ideally PostgreSQL) and a DICOM server, then install OpenREM and its dependencies with pip. The guides are based on Ubuntu Server.
Native Windows: supported on Windows Server with IIS, PostgreSQL and a DICOM server. The docs advise against Windows 10/11 for production because they are not server operating systems.
Gotchas: OpenREM 1.0 needs a different Python version from 0.10, so upgrades follow the published upgrade guides rather than an in-place update. The server should have internet access for Docker images and security updates. If it cannot, the docs describe an offline installation. Plan who will map protocol names, because charts are only useful after that step.
Limitations
- The stable release is from 2019, and 1.0 is still labelled beta, although it is the version the documentation now covers.
- It needs a server and some Linux/Docker or Windows Server administration skills. It is not a program you install on a reception PC.
- It has no dental-specific features or verified support for intraoral or CBCT dose data.
- It is a monitoring and audit tool. Interpreting the numbers needs a qualified medical physicist.
- It is not an image viewer or archive.
OpenREM vs alternatives
OpenREM does not really compete with the other tools in this catalogue, because it is one of the few free dose-monitoring systems. The main alternatives are the commercial dose-management modules that imaging vendors and PACS suppliers sell. If your dental group only needs to move DICOM data between devices, dcm4che provides free command-line DICOM tools. To inspect the DICOM headers of a unit and see which dose fields it writes, a viewer such as Sante DICOM Viewer or ImageJ / Fiji can show the tags before you commit to OpenREM.
FAQ
Is OpenREM free?
Yes. It is free, open-source software under GPLv3 with additional permissions.
What is the latest OpenREM version?
The latest stable release is 0.10.0 (November 2019). Version 1.0 is in beta (1.0.0b3, February 2026), and the current documentation describes 1.0.
Can OpenREM be installed with Docker?
Yes. For 1.0, Docker is the documented quickest option and includes the database, web server and DICOM server.
Does OpenREM support dental X-ray units?
There is no dental module. The 1.0 series imports panoramic (PX) exams into the radiographic section. Support for CBCT or intraoral units depends on the dose data each unit exports.
Which modalities does OpenREM cover?
CT, radiography, fluoroscopy and mammography, plus nuclear medicine charts in the 1.0 series.
Does OpenREM run on Windows?
Yes, on Windows Server with IIS, or on Windows 10 through Docker Desktop. Windows 10/11 are not recommended for production.
Who develops OpenREM?
The OpenREM open-source project, started by Ed McDonagh at The Royal Marsden NHS Foundation Trust, with source code hosted on Bitbucket.
Last checked against official sources: 29 September 2026 (developer website: openrem.org). Versions and licence terms change — confirm on the developer's site before deploying in a clinic.
