What I find interesting and frustrating about DICOM is many imagers include the HUD in the actual image component of the file. DICOM is full of metadata, and, for example, the Phillips ultrasound units our baby scans have been done with include patient name and data in the image.
Loading these images up in something like OsiriX (a DICOM viewer for mac) then go ahead and superimpose the metadata in the DICOM file over the metadata visually-encoded in the image . Yo dawg, I herd u liek metadata! Sigh.