CVE-2015-8396 in DICOM
Summary
by MITRE
Integer overflow in the ImageRegionReader::ReadIntoBuffer function in MediaStorageAndFileFormat/gdcmImageRegionReader.cxx in Grassroots DICOM (aka GDCM) before 2.6.2 allows attackers to execute arbitrary code via crafted header dimensions in a DICOM image file, which triggers a buffer overflow.
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Analysis
by VulDB Data Team • 08/21/2025
The vulnerability identified as CVE-2015-8396 represents a critical integer overflow flaw within the Grassroots DICOM (GDCM) software library, specifically affecting the ImageRegionReader::ReadIntoBuffer function in the MediaStorageAndFileFormat/gdcmImageRegionReader.cxx source file. This issue exists in GDCM versions prior to 2.6.2 and creates a dangerous condition where maliciously crafted DICOM image files can trigger arbitrary code execution on systems that process these medical imaging files. The flaw stems from insufficient input validation and improper handling of header dimensions within DICOM file structures, which are commonly used in healthcare information systems and medical imaging workflows.
The technical implementation of this vulnerability involves an integer overflow condition that occurs when the application attempts to calculate buffer sizes based on malformed header dimensions found in DICOM files. When attackers manipulate the width and height values within the DICOM file headers, they can cause the integer arithmetic to overflow, resulting in a significantly smaller buffer allocation than required for the actual image data. This buffer under-allocation creates a condition where subsequent memory operations attempt to write beyond the allocated buffer boundaries, leading to memory corruption that can be exploited to execute arbitrary code. The vulnerability operates at the intersection of memory safety and input validation, making it particularly dangerous in environments where medical imaging files are processed automatically.
The operational impact of CVE-2015-8396 extends beyond simple code execution, as it represents a serious threat to healthcare information systems that rely on GDCM for DICOM file processing. Medical imaging systems, PACS (Picture Archiving and Communication Systems), and radiology workstations that use GDCM libraries are at risk of being compromised through the injection of malicious DICOM files. Attackers can leverage this vulnerability to gain unauthorized access to medical imaging servers, potentially leading to data breaches of sensitive patient information, system compromise, or disruption of critical healthcare services. The attack vector is particularly concerning because DICOM files are routinely exchanged between healthcare facilities and are often processed automatically without human intervention, making the exploitation of this vulnerability highly automated and difficult to detect.
This vulnerability maps directly to CWE-190, Integer Overflow or Wraparound, which specifically addresses the issue of integer arithmetic overflow leading to buffer overflows and memory corruption. The attack scenario aligns with ATT&CK technique T1059.007 for Command and Scripting Interpreter: Visual Basic, as attackers can potentially use this vulnerability to execute malicious code within the target environment. The remediation approach requires immediate patching of GDCM installations to version 2.6.2 or later, where proper integer overflow checks and input validation have been implemented. Organizations should also implement network segmentation and file validation controls to prevent the processing of untrusted DICOM files, while monitoring for suspicious file processing activities. Additionally, the vulnerability highlights the importance of proper input validation in medical imaging software, as healthcare systems often process files from multiple sources without adequate sanitization, creating potential attack surfaces for sophisticated adversaries targeting healthcare infrastructure.