Since 1994, the ATC® has been an active participant in the DICOM standards process. As a member of DICOM Working Group 7, the ATC®, represented by Dr. Walter Bosch, contributed to the development of the DICOM RT Information Objects.  Between 1995 and 2004, the ATC® hosted a series of six Technical Workshops to assist TP vendors in developing consistent RTOG Data Exchange and DICOM export capabilities that could be used to capture TP datasets for clinical trials. To promote the adoption of consistent DICOM export capabilities among radiotherapy treatment planning vendors, the ATC® published a DICOM Conformance Statement describing the behavior and requirements of the File Set Reader used to receive clinical trials datasets at the ATC® and giving specific requirements for the DICOM objects and attributes used in these datasets.  In 2004, the ATC® helped organize a joint demonstration with AAPM and NEMA of the exchange of DICOM RT objects at the AAPM 2004 Annual Meeting.

Since 2004, the ATC® has participated in the IHE Radiation Oncology Domain (IHE-RO), as a member of the IHE-RO Technical Committee (Dr. Bosch) and, since 2008, the ATC has been an Organizational Member of IHE International.  As a member of the IHE-RO Test Committee, Dr. Bosch has participated in 18 Connectathons (2007-2022) and six Domain Pre-testing events (2006, 2009-2013).  The ATC® hosted the 2012 IHE-RO Domain Pre-testing at its facilities in St. Louis.  Test datasets for each of these test events were created using ATC® scripts and utilities.  For the past several years, the FileDistApp, a portable, web-based DICOM utility derived from the Perl Open-Source DICOM Archive (POSDA) toolkit has been used to generate DICOM test objects for the IHE-RO Connectathon and Domain Pre-Testing events.  The POSDA toolkit is easily scripted to extract, modify, and test DICOM objects.  Numerous special purpose scripts have been created to check for and correct errors in DICOM clinical trials datasets, e.g., to repair references to image instances in RT Structure Sets.  These scripts are available for use or adaptation in creating DICOM datasets.