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High-resolution 3D medical image data are typically huge in volume, varying from several hundred megabytes to several dozen gigabytes. Since such large-size data sets severely stress storage systems and networks, most existing Web-based interactive 3D medical imaging applications, such as 3D slicer and region-of-interest viewing, deal with only low-or medium-resolution images. In this paper, we introduce a single instance storage design, a client sharing technique, and a corresponding query processing method to enhance our existing remote medical image viewing system. We give performance results to show that the new design can significantly reduce storage and communication bandwidth requirements. Furthermore, it is more scalable to support a larger number of concurrent users.