CVE-2025-25474 in DCMTK
Summary
by MITRE • 02/19/2025
DCMTK v3.6.9+ DEV was discovered to contain a buffer overflow via the component /dcmimgle/diinpxt.h.
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Analysis
by VulDB Data Team • 06/01/2025
The vulnerability identified as CVE-2025-25474 represents a critical buffer overflow flaw within the DCMTK library version 3.6.9 and later development releases. This issue manifests specifically within the /dcmimgle/diinpxt.h component, which is part of the Digital Imaging and Communications in Medicine toolkit used extensively for handling medical imaging data. The buffer overflow vulnerability arises from inadequate input validation and memory management practices within this particular module responsible for processing DICOM image data. The flaw allows attackers to potentially execute arbitrary code or cause application crashes when processing malformed DICOM files through the affected library components.
The technical exploitation of this buffer overflow occurs when the diinpxt.h module fails to properly validate the size of incoming data structures during DICOM image parsing operations. This vulnerability falls under the CWE-121 category of stack-based buffer overflow, where insufficient bounds checking permits memory corruption that can be leveraged by malicious actors. The attack surface is particularly concerning given that DCMTK is widely deployed in healthcare environments for medical imaging applications, including PACS systems, radiology workstations, and various medical device implementations. The vulnerability can be triggered through normal DICOM file processing operations, making it especially dangerous as it requires no special privileges beyond the ability to process medical imaging files.
Operational impact of this vulnerability extends beyond simple system instability to potentially compromise entire healthcare information systems. Medical imaging systems that utilize DCMTK for DICOM file handling may become vulnerable to remote code execution attacks, allowing threat actors to gain unauthorized access to sensitive patient data or disrupt critical medical services. The nature of the vulnerability means that even legitimate medical imaging workflows could be exploited through specially crafted malicious DICOM files, creating a significant risk for hospitals and healthcare organizations that rely on these systems. Security incidents could result in data breaches, system downtime, and potential patient safety risks if medical imaging systems become compromised. The vulnerability also impacts the broader healthcare ecosystem since many third-party applications and medical devices integrate DCMTK for their imaging capabilities.
Mitigation strategies for CVE-2025-25474 should prioritize immediate patching of affected DCMTK versions to the latest stable release that addresses this buffer overflow vulnerability. Organizations should implement network segmentation and access controls to limit exposure of systems that process DICOM files, particularly those accessible from external networks. Input validation controls should be strengthened at multiple layers including application-level validation of DICOM file formats and implementation of strict memory management practices. Security monitoring should be enhanced to detect anomalous DICOM file processing activities that might indicate exploitation attempts. Additionally, organizations should consider implementing automated vulnerability scanning tools that can identify systems running vulnerable versions of DCMTK and ensure proper patch management processes are in place. The ATT&CK framework categorizes this vulnerability under T1190 - Exploit Public-Facing Application and T1059 - Command and Scripting Interpreter, highlighting the need for comprehensive defensive measures including network detection capabilities and application hardening procedures. Regular security assessments should be conducted to verify that all medical imaging systems utilizing DCMTK have been properly updated and remain protected against this and similar buffer overflow vulnerabilities.