Digital medical images require anonymization of Protected Health Information in the DICOM header and in "burned-in" text. One might wonder why we are still struggling with anonymization after so many years of experience. The answer is that it is complicated! Anonymization of medical images has been a challenge ever since digital medical imaging was introduced", said Herman Oosterwijk, President of OTech. "When it was film-based, de-identifying an image was easy: One would simply cut off the corner of the film that included the patient information, or when making a duplicate, one would cover the patient information or obscure it with a black marker."