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DICOM Connections Troubleshooting Guide

My study is not sending to PACS

If you have an existing DICOM connection from Butterfly Cloud to your PACS, VNA, or Modality Worklist systems, follow the steps below if you encounter problems. If you’re noticing that your studies are not syncing to PACS/VNA and/or noticing any of the following examples:

  • Exams with a red exclamation mark
    • 15ecf10188ef89.png
  • Exams with a spinning wheel
    • 15ecf10187c6ba.png

You may have a connectivity problem. Below are actions that you can take based on your user type within Butterfly Cloud to mitigate the issue.


Regular User:

When you are saving the study using the Butterfly app, ensure that you are selecting the archive that is associated with your DICOM destination.


Verify that the connection is not paused. If you continually see a spinning PACS icon in the lower right of the study then the connection may be paused.


Contact Organization Administrator or Enterprise Administrator so they can take appropriate actions to unpause connection.


Organization Administrator

Click on 3 dots located in the upper right corner of the image. Attempt to re-send the study using the Endpoints menu. If the send fails, escalate to the Enterprise Administrator.



Enterprise Administrator:

Click your username in the upper right corner of the window and select Organization Settings. Select the Connectivity tab and locate your PACS connection under the Integration section.



The message “Studies could not be synced” indicates that your connection is Paused due to an error that occurred. Select Resume and watch to make sure that the connection does not indicate a failure after resuming.


If the study fails to send to PACS, perform a DICOM Echo to ensure that Butterfly Cloud can still communicate with your PACS.


Steps to take:

  1. Access the Connectivity tab within Enterprise Settings and verify that the PACS connection is       not "Paused" - if so un-Pause.KB_Dicom_Troubleshooting_Image_Enterprise_Pause.PNG

  2. Perform a DICOM Echo to ensure that Butterfly Cloud can still communicate with your PACS. KB_Dicom_Troubleshooting_Image_Enterprise_Echo.PNGClick Echo to refresh the Echo results.KB_Dicom_Troubleshooting_Image_Enterprise_EchoOutput.PNG

  3. Verify that the Butterfly Link service which is used for that PACS integration is not showing “Connection inactive”. If the Butterfly Link is showing “Connection inactive” - restart the Butterfly Link services on the Windows server that hosts the service.

    Watch for the Butterfly Link to no longer show “connection inactive” status and re- send the exam.


  4. Review the Log file associated with the PACS connection. Check for obvious errors or issues in the PACS integration log file. KB_Dicom_Troubleshooting_Image_Logs.PNGKB_Dicom_Troubleshooting_Image_LogsExample.PNG

    Check the log files on your PACS system to determine if a DICOM connection request is being received by the PACS.  If there is connectivity but failure to transmit the entire study this may be related to a transfer syntax issue and/or connection timeout.


     Increasing the DIMSE/ACSE transmission timeout or changing the transfer syntax settings to Jpeg Baseline (this transfer format results in the smallest data size, especially for large US cine-clips). Follow these steps: Connectivity, Integrations, locate PACS with failure, and click on the 3 dots, Edit, make changes to as seen below.



     Attempt to re-send the exam. If not successful please contact Butterfly Support. 

  5. Contact Butterfly Support - support@butterflynetwork.com. Provide details of the issue, and include a portion of the log file data that shows the error. KB_Dicom_Troubleshooting_Image_Logs.PNGCopy and paste the entire log file contents into your email to Butterfly Support.KB_Dicom_Troubleshooting_Image_PACSLogs.PNG

Not all presets, imaging modes and features are available everywhere. Check for availability in your country.

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