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DICOM considers a communication between two application entities on a direct association only. Since it is very useful to perform communications on a standardized base, we extended the meaning of DICOM communication from a local to an inter-institutional view. For the purpose of forwarding a dataset from one to another application via an unlimited number of networks, we developed a set of DICOM-to-DICOM gateways. The communication is performed by extended C-STORE and C-MOVE DIMSE services. Legal requirements for transmission control are satisfied by access controls on both TCP/IP and DICOM levels. The transfer of conventional ACR-NEMA 1.0 or 2.0 datasets was included by adding a private SOP class that preserves the original dataset format.