DICOM was not designed for Cloud/VNA (aka Wide Area Network) Servers 

The DICOM protocol was developed to target intranets to support medical imaging in a single hospital not the internet or cloud.


D.3.3.3 Asynchronous Operations (And Sub-Operations) Window Negotiation
https://dicom.nema.org/medical/dicom/current/output/chtml/part07/sect_D.3.3.3.html

To C-MOVE is human; to C-GET, divine
https://dclunie.blogspot.com/2016/05/to-c-move-is-human-to-c-get-divine.html

Understanding DICOM with Orthanc: Using HTTP instead of the DICOM protocol
https://book.orthanc-server.com/dicom-guide.html?highlight=file%20system#using-http-instead-of-the-dicom-protocol

