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Amazon HealthImaging as External Storage

Amazon HealthImaging (AHI) is an AWS-managed datastore for DICOM imaging data. For details about the service itself — its capabilities, regions, and intended use cases — see the AWS HealthImaging documentation.

This page describes how AHI is supported as an External Storage provider in Flywheel: what is configurable, how it differs from blob-based storage, and what to expect when running Bulk Import and Bulk Export jobs that use it.

Added in version 22.0.0

Support for AHI as a Bulk Import source and a Bulk Export destination was added in Flywheel Core 22.0.0.

How AHI Differs from Blob Storage

AHI uses a DICOM-based storage model rather than a blob-oriented one. This results in several user-facing differences compared to S3, Azure Blob, or GCS:

Behavior Blob Storage (S3, Azure, GCS) Amazon HealthImaging
File model Arbitrary objects organized by path/prefix DICOM ImageSets organized by datastore
Path/prefix configuration Required Not applicable
Overwrite handling Configurable per export job Managed by AHI; not user-configurable
Delete pre-existing files Available as a setting Not applicable
File-format support Any DICOM Part 10 (P10) compliant files only
Storage prefix override Available Not applicable

Because AHI does not use a path/prefix model, the storage prefix, overwrite handling, and delete pre-existing files options are not shown in the export form when AHI is selected as the destination.

DICOM Part 10 compliance required for AHI exports

AHI accepts only DICOM Part 10 (P10) compliant files. Non-P10-compliant files in your project are skipped during export and reported in the export audit log.

Starting in version 21.6.0, Bulk Import automatically checks DICOM files for P10 compliance and records the result as file metadata. Use this metadata when configuring AHI export filters to ensure only compliant files are included. See Bulk Import - Default Behavior for details.

Configuring an AHI Datastore as External Storage

Prerequisites

Before registering an AHI datastore in Flywheel:

  1. Create an AHI datastore in your AWS account in a supported AWS region. See AWS — Creating a data store for instructions.
  2. Note the datastore ID and region. You will need both values when registering the storage in Flywheel.
  3. Configure an IAM principal with the permissions required for the Flywheel transfer service to read from or write to the datastore (see AWS Access Policy).

Registering AHI in Flywheel

AHI datastores are registered through the same External Storage screen used for blob storage providers. Follow the steps in How to Configure an External Storage and select AHI as the provider type.

When AHI is selected, the configuration form requires the AHI datastore ID and region in place of the bucket/prefix fields used for blob storage.

Assign the appropriate permission mode for the registration:

  • Import only — Users can import data from the datastore but cannot export to it.
  • Export only — Users can export data to the datastore but cannot import from it.
  • Both — Users can use the datastore for both import and export jobs.

AWS Access Policy

The IAM principal used by Flywheel to access the AHI datastore requires different permissions depending on the permission mode assigned to the registration.

Import (Read) Permissions

For import-only registrations, the IAM principal requires read access to the datastore:

  • medical-imaging:GetDatastore
  • medical-imaging:ListImageSets (or medical-imaging:SearchImageSets)
  • medical-imaging:GetImageSet
  • medical-imaging:GetImageSetMetadata
  • medical-imaging:GetImageFrame

Export (Write) Permissions

For export-enabled registrations, the IAM principal additionally requires write access:

  • medical-imaging:StartDICOMImportJob
  • medical-imaging:GetDICOMImportJob

Refer to the AWS HealthImaging IAM documentation for the most up-to-date list of required permissions.

Importing from AHI

After an AHI datastore is registered with import permission, it appears as an option in the External Storage picker when starting a Bulk Import job from the Web App or the New CLI (flyw).

The import workflow is the same as for blob storage sources:

  1. Start a new Bulk Import.
  2. Select the AHI datastore as the source.
  3. Configure rules or select a rule set as you would for any other Bulk Import.
  4. Start the import.

For step-by-step instructions, see How to Run a Bulk Import.

Exporting to AHI

After an AHI datastore is registered with export permission, it appears as an option in the Export Destination picker when starting a Bulk Export job.

The export workflow is similar to other destinations, with these AHI-specific behaviors:

  • The export form does not show Storage Prefix, Overwrite Handling, or Delete Pre-Existing Files options. These do not apply to the DICOM-based AHI storage model.
  • Only DICOM Part 10 (P10) compliant files are accepted. Non-compliant files are skipped and reported in the export audit log. Use P10 compliance filters to select only compliant files at job time.

For step-by-step instructions, see How to Start a New Bulk Export Job.

Further Reading