An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through 2019b. The preamble of a DICOM file that complies with this specification can contain the header for an executable file, such as Portable Executable (PE) malware. This space is left unspecified so that dual-purpose files can be created. (For example, dual-purpose TIFF/DICOM files are used in digital whole slide imaging for applications in medicine.) To exploit this vulnerability, someone must execute a maliciously crafted file that is encoded in the DICOM Part 10 File Format. PE/DICOM files are executable even with the .dcm file extension. Anti-malware configurations at healthcare facilities often ignore medical imagery. Also, anti-malware tools and business processes could violate regulatory frameworks (such as HIPAA) when processing suspicious DICOM files.