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---
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sidebar_position: 9
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---
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# Nginx + Image Archive
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> DISCLAIMER! We make no claims or guarantees of this approach's security. If in
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> doubt, enlist the help of an expert and conduct proper audits.
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At a certain point, you may want others to have access to your instance of the
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OHIF Viewer and its medical imaging data. This post covers one of many potential
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setups that accomplish that. Please note, noticeably absent is user account
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control.
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Do not use this recipe to host sensitive medical data on the open web. Depending
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on your company's policies, this may be an appropriate setup on an internal
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network when protected with a server's basic authentication.
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## Overview
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Our two biggest hurdles when hosting our image archive and web client are:
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- Risks related to exposing our PACS to the network
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- Cross-Origin Resource Sharing (CORS) requests
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### Handling Web Requests
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We mitigate our first issue by allowing [Nginx][nginx] to handle incoming web
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requests. Nginx is open source software for web serving, reverse proxying,
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caching, and more. It's designed for maximum performance and stability --
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allowing us to more reliably serve content than Orthanc's built-in server can.
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More specifically, we accomplish this by using a
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[`reverse proxy`](https://en.wikipedia.org/wiki/Reverse_proxy) to retrieve
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resources from our image archive (Orthanc), and when accessing its web admin.
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> A reverse proxy is a type of proxy server that retrieves resources on behalf
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> of a client from one or more servers. These resources are then returned to the
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> client, appearing as if they originated from the proxy server itself.
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### CORS Issues
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Cross-Origin Resource Sharing (CORS) is a mechanism that uses HTTP headers to
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tell a browser which web applications have permission to access selected
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resources from a server at a different origin (domain, protocol, port). IE. By
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default, a Web App located at `http://my-website.com` can't access resources
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hosted at `http://not-my-website.com`
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We can solve this one of two ways:
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1. Have our Image Archive located at the same domain as our Web App
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2. Add appropriate `Access-Control-Allow-*` HTTP headers
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**This solution uses the first approach.**
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You can read more about CORS in this Medium article: [Understanding
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CORS][understanding-cors]
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### Diagram
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This setup allows us to create a setup similar to the one pictured below:
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- All web requests are routed through `nginx` on our `OpenResty` image
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- `/pacs` is a reverse proxy for `orthanc`'s `DICOM Web` endpoints
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- `/pacs-admin` is a reverse proxy for `orthanc`'s Web Admin
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- All static resources for OHIF Viewer are served up by `nginx` when a matching
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route for that resource is requested
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## Getting Started
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### Requirements
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- Docker
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- [Docker for Mac](https://docs.docker.com/docker-for-mac/)
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- [Docker for Windows](https://docs.docker.com/docker-for-windows/)
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_Not sure if you have `docker` installed already? Try running `docker --version`
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in command prompt or terminal_
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### Setup
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- Navigate to `app` folder inside `platform`
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- then: `cd .recipes/OpenResty-Orthanc`
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- run: `docker-compose up --build`
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- Navigate to `127.0.0.1` for the viewer
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- Navigate to `127.0.0.1/pacs-admin` for uploading studies via the UI, or send studies via DIMSE C-STORE to `ORTHANC@127.0.0.1:4242` (hint: you can use utilites like dcm4che's `storescu` to send studies in bulk via the command line)
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You can see the overview of the mentioned steps:
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<div style={{padding:"56.25% 0 0 0", position:"relative"}}>
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<iframe src="https://player.vimeo.com/video/843233827?badge=0&autopause=0&player_id=0&app_id=58479" frameBorder="0" allow="autoplay; fullscreen; picture-in-picture" allowFullScreen style= {{ position:"absolute",top:0,left:0,width:"100%",height:"100%"}} title="measurement-report"></iframe>
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</div>
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<!-- ### Setup
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_Spin Things Up_
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- Navigate to `<project-root>/docker/OpenResty-Orthanc` in your shell
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- Run `docker-compose up`
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_Upload Your First Study_
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- Navigate to `http://127.0.0.1/pacs-admin`
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- From the top right, select "Upload"
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- Click "Select files to upload..." (DICOM)
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- Click "Start the upload"
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- Navigate back to `http://127.0.0.1/` to view your studies in the Study List -->
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### Troubleshooting
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_Exit code 137_
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This means Docker ran out of memory. Open Docker Desktop, go to the `advanced`
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tab, and increase the amount of Memory available.
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_Cannot create container for service X_
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Use this one with caution: `docker system prune`
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_X is already running_
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Stop running all containers:
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- Win: `docker ps -a -q | ForEach { docker stop $_ }`
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- Linux: `docker stop $(docker ps -a -q)`
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_Traceback (most recent call last):_
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_File "urllib3/connectionpool.py", line 670, in urlopen_
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_...._
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Are you sure your docker is running? see explanation [here](https://github.com/docker/compose/issues/7896)
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### Configuration
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After verifying that everything runs with default configuration values, you will
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likely want to update:
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- The domain: `http://127.0.0.1`
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#### OHIF Viewer
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The OHIF Viewer's configuration is imported from a static `.js` file. The
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configuration we use is set to a specific file when we build the viewer, and
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determined by the env variable: `APP_CONFIG`. You can see where we set its value
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in the `dockerfile` for this solution:
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`ENV APP_CONFIG=config/docker_openresty-orthanc.js`
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You can find the configuration we're using here:
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`/public/config/docker_openresty-orthanc.js`
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To rebuild the `webapp` image created by our `dockerfile` after updating the
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Viewer's configuration, you can run:
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- `docker-compose build` OR
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- `docker-compose up --build`
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#### Other
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All other files are found in: `/docker/OpenResty-Orthanc/`
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| Service | Configuration | Docs |
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| ----------------- | --------------------------------- | ------------------------------------------- |
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| OHIF Viewer | [dockerfile][dockerfile] | You're reading them now! |
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| OpenResty (Nginx) | [`/nginx.conf`][config-nginx] | [lua-resty-openidc][lua-resty-openidc-docs] |
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| Orthanc | [`/orthanc.json`][config-orthanc] | [Here][orthanc-docs] |
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## Next Steps
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### Deploying to Production
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While these configuration and docker-compose files model an environment suitable
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for production, they are not easy to deploy "as is". You can either:
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- Manually recreate this environment and deploy built application files **OR**
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- Deploy to a cloud kubernetes provider like
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[Digital Ocean](https://www.digitalocean.com/products/kubernetes/) **OR**
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- [See a full list of cloud providers here](https://landscape.cncf.io/category=cloud&format=card-mode&grouping=category)
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- Find and follow your preferred provider's guide on setting up
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[swarms and stacks](https://docs.docker.com/get-started/)
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### Adding SSL
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Adding SSL registration and renewal for your domain with Let's Encrypt that
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terminates at Nginx is an incredibly important step toward securing your data.
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Here are some resources, specific to this setup, that may be helpful:
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- [lua-resty-auto-ssl](https://github.com/GUI/lua-resty-auto-ssl)
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- [Let's Encrypt + Nginx](https://www.nginx.com/blog/using-free-ssltls-certificates-from-lets-encrypt-with-nginx/)
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While we terminate SSL at Nginx, it may be worth using self-signed certificates
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for communication between services.
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- [SSL Termination for TCP Upstream Servers](https://docs.nginx.com/nginx/admin-guide/security-controls/terminating-ssl-tcp/)
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### Use PostgresSQL w/ Orthanc
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Orthanc can handle a large amount of data and requests, but if you find that
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requests start to slow as you add more and more studies, you may want to
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configure your Orthanc instance to use PostgresSQL. Instructions on how to do
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that can be found in the
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[`Orthanc Server Book`](http://book.orthanc-server.com/users/docker.html), under
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"PostgreSQL and Orthanc inside Docker"
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### Improving This Guide
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Here are some improvements this guide would benefit from, and that we would be
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more than happy to accept Pull Requests for:
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- SSL Support
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- Complete configuration with `.env` file (or something similar)
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- Any security issues
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- One-click deploy to a cloud provider
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## Resources
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### Misc. Helpful Commands
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_Check if `nginx.conf` is valid:_
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```bash
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docker run --rm -t -a stdout --name my-openresty -v $PWD/config/:/usr/local/openresty/nginx/conf/:ro openresty/openresty:alpine-fat openresty -c /usr/local/openresty/nginx/conf/nginx.conf -t
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```
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_Interact w/ running container:_
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`docker exec -it CONTAINER_NAME bash`
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_List running containers:_
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`docker ps`
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### Referenced Articles
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For more documentation on the software we've chosen to use, you may find the
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following resources helpful:
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- [Orthanc for Docker](http://book.orthanc-server.com/users/docker.html)
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- [OpenResty Guide](http://www.staticshin.com/programming/definitely-an-open-resty-guide/)
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- [Lua Ngx API](https://openresty-reference.readthedocs.io/en/latest/Lua_Nginx_API/)
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For a different take on this setup, check out the repositories our community
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members put together:
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- [mjstealey/ohif-orthanc-dimse-docker](https://github.com/mjstealey/ohif-orthanc-dimse-docker)
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- [trypag/ohif-orthanc-postgres-docker](https://github.com/trypag/ohif-orthanc-postgres-docker)
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<!--
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Links
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-->
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<!-- prettier-ignore-start -->
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<!-- DOCS -->
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[nginx]: https://www.nginx.com/resources/glossary/nginx/
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[understanding-cors]: https://medium.com/@baphemot/understanding-cors-18ad6b478e2b
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[orthanc-docs]: http://book.orthanc-server.com/users/configuration.html#configuration
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[lua-resty-openidc-docs]: https://github.com/zmartzone/lua-resty-openidc
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<!-- SRC -->
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[dockerfile]: https://github.com/OHIF/Viewers/blob/master/platform/app/.recipes/OpenResty-Orthanc/dockerfile
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[config-nginx]: https://github.com/OHIF/Viewers/blob/master/platform/app/.recipes/OpenResty-Orthanc/config/nginx.conf
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[config-orthanc]: https://github.com/OHIF/Viewers/blob/master/platform/app/.recipes/OpenResty-Orthanc/config/orthanc.json
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<!-- prettier-ignore-end -->
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