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Background and Objective: Nowadays usage paradigms of medical imagingresources are requesting vendor-neutral archives, accessible through standardinterfaces, with multi-repository support. Regional repositories shared bydistinct institutions, teleradiology as a service at Cloud, teaching andresearch archives, are illustrative examples of this new reality. However,traditional production environments have a server archive instance perfunctional domain where every registered client application has access to allstudies. This paper proposes an innovator ownership concept and access controlmechanisms that provide a multi-repository environment and integrates well withstandard protocols.  Methods: A secure accounting mechanism for medical imaging repositories weredesigned and instantiated as an extension of a well-known open-source archive.A new Web services layer was implemented to provide a vendor-neutral solutioncomplaint with modern DICOM-Web protocols for storage, search and retrieve ofmedical imaging data.  Results: The concept validation was done through the integration of proposedarchitecture in an open-source solution. A quantitative assessment wasperformed for evaluating the impact of the mechanism in the usual DICOM Weboperations.  Conclusions: This article proposes a secure accounting architecture able toeasily convert a standard medical imaging archive server in a multi-repositorysolution. The proposal validation was done through a set of tests thatdemonstrated its robustness and usage feasibility in a production environment.The proposed system offers new services, fundamental in a new era ofCloud-based operations, with acceptable temporal costs.

A Cloud-ready Architecture for Shared Medical Imaging Repository