Records and DICOM: What to Send in 2026
Quick answer: send everything, keep the original language, and send the images — not just the reports. A hospital can usually review a case within days when the file set is complete: discharge summaries, operative notes, histopathology with immunohistochemistry, imaging reports, lab trends, a medication list with doses and an allergy list — plus the raw DICOM files from every relevant scan, not only the latest.
What to send: the document list
Hospitals ask for everything because the treating team must rebuild a history it did not witness, and one missing document delays a decision. The name on the records must match the passport.
| Document | What it must contain | Common mistake |
|---|---|---|
| Discharge summaries | Every admission, in date order | Only the latest admission |
| Operative notes | Procedure, findings, implants, complications | The bill instead of the note |
| Histopathology and IHC | Grade, stage, margins, receptor status, molecular tests | Biopsy report missing |
| Imaging reports | The radiologist's text for each study | Treated as a substitute for images |
| Lab trends | Serial values with dates and units | One isolated result |
| Medication list | Generic name, dose, frequency, start date | Brand names only |
| Allergy list | Substance and the reaction it caused | Unverified "no allergies" |
Two extras are worth adding: a one-page timeline in plain language, and implant details — brand, model, serial — if revision surgery is possible.
Why DICOM is not a PDF or a JPG — and the detail most patients get wrong
DICOM is the scan itself; a JPG is a photograph of one view of it, and a PDF report is one radiologist's opinion about it. DICOM carries the measured values: pixel data at far higher bit depth, plus slice thickness, slice spacing, acquisition settings and patient position. That lets a surgeon measure a lesion, a radiation oncologist contour a target, or a radiologist compare tissue density. A JPG is lossily compressed and locked to one window setting: what the other settings showed is gone, and a lesion's margins are what compression damages.
The detail most patients get wrong is twofold: they send imaging reports instead of the images, and they send only the newest scan instead of the series showing change over time. A report is someone else's conclusion; a single scan is one frame. Growth, response and stability are comparisons — so send the baseline, the interval studies and the latest, plus the original biopsy pathology, not only the post-treatment specimen. Without images the review stalls, files get requested again, and radiotherapy planning cannot begin.
Getting DICOM out of the hospital, and getting it to us
Ask radiology for the original DICOM data on disc, USB or a download link — not a printed film or the report. Bring photo ID, and a signed authorisation if someone else collects. Then check the disc yourself with a free DICOM viewer: it is sometimes written with the wrong study or a missing series.
- File size. A CT of one region is often a few hundred MB; a PET-CT can exceed a gigabyte; a multi-sequence MRI with years of history can reach tens of gigabytes. Download links expire in days — download at once and keep two copies.
- Transfer. Use an encrypted cloud folder or a secure transfer service with an expiring link, sending the password by a separate channel. For very large sets, courier the disc.
- Plain email is the wrong channel. It is not end-to-end encrypted and attachment limits sit near 20–25 MB. If a hospital insists, send a password-protected archive and pass the password separately. Avoid "anyone with the link" sharing.
Translation, and what must never be translated
We translate discharge summaries, operative notes, pathology and IHC reports, imaging reports, medication lists, lab tables and the timeline. What must never happen is replacing the original with a translation. The original is the legal record; drug names, doses and units can shift; pathology wording — grade, stage, receptor status, gene fusions — must be exact; and only the original reveals a mistyped number. Keep both, labelled by language and date.
A working translation is not a certified translation, which some hospitals and insurers require. Ask which is needed before paying for certification.
Privacy: encrypted channels and where your records live
These are among the most sensitive documents you own — genetics, HIV status, mental health, fertility. Send them over an encrypted channel, not plain email, and ask the recipient directly: where will these records be stored, who can open them, how long are they kept, will the transfer cross a border, and how do I have them deleted? Get it in writing; if an intermediary cannot answer, do not send. Redact what is not clinically needed — national ID, insurance numbers, home address.
How TFUCare helps
Records translation, appointment coordination with the international department, airport pickup, bilingual accompaniment. Medical fees are paid directly to the hospital, never through us. Start with a free case review.
We will say when a file set is too thin for a useful review rather than forward it and let you wait — and we will not promise the review produces the answer you hope for.
Questions we get about this
What is the single thing patients most often get wrong?
Sending the radiology report instead of the images. A report is one radiologist's summary of what they saw; the surgeon needs the raw DICOM series to plan an operation, measure a lesion and compare it with earlier scans. A PDF or a phone photograph of a film is not a substitute — the measurement precision is gone. The second most common mistake is sending only the most recent scan: the change between the older and newer images is often what decides whether a case is operable.
How long does it take to get an answer?
About 24 hours on business days from the free case review. That first reply names one hospital we would point you to, gives a realistic cost range drawn from published figures, and says whether China is a sensible option for your condition at all. If the hospital has to review imaging before it will commit, expect two to four working days instead — we tell you which of the two it will be before you send anything, so you are never waiting without knowing why. Cases that need a named specialist's opinion rather than a department's take weeks, not days, and we say so rather than let the clock run.
What do you charge, and who do I pay?
The case review is free and carries no obligation. Two paid levels follow it, with the amounts published on our pricing page: a Hospital Acceptance Check, which puts your case in front of hospitals and brings back their written answer, and Full Journey Management, which covers preparation, appointments, visa invitation letter, airport pickup, bilingual accompaniment and follow-up. Medical fees are always paid by you directly to the hospital — we never handle treatment funds, and no invoice of ours ever contains a hospital charge. That separation is deliberate: it is the strongest protection against the deposit scams this industry is known for.
Can I enter China visa-free for treatment?
Not on the ordinary visa-free route, and this is the correction most websites get wrong. The officially listed permitted purposes are business, tourism, family visits, exchange and transit — medical treatment is not among them, and border inspection may refuse entry where the stated purpose does not match the visa-free rules. A trip whose main purpose is treatment therefore needs an M visa, normally supported by an invitation letter from the treating hospital, which we help prepare. Short consultations, check-ups and imaging can legitimately sit inside an ordinary visit, and we will tell you honestly which side of the line your case falls on.
Does anyone speak English at the hospital?
Inside the international department, yes — the coordinators and many of the physicians are bilingual, and some trained in the US, UK or Germany. Outside it, English is limited, and that boundary is where problems start: the pharmacy, the billing window, the imaging reception and the ward nurses may have no English at all. That is precisely why a coordinator accompanies you through registration, consultation, imaging, admission and discharge rather than leaving you to manage alone, and why we translate your records into Chinese before you arrive rather than during the appointment.