Annotation burn-in (or removal)

Burn annotations into the pixels, or strip burned-in annotations back out.

Problem

DICOM images may contain burned-in annotations — text overlays, measurement callouts, or scanner-generated graphics — embedded directly in the pixel data. These annotations can be PHI or simply clutter that interferes with downstream analysis. You need to either permanently burn them into a copy or redact them from the image.

Steps

1. Open the DICOM file — click Open files… (⌘O).
2. Detect burned-in text — switch to Anon mode (⌘2) and click Detect text (OCR). The system scans the pixel data for text overlays and proposes redaction regions.
3. Review OCR proposals — green bounding boxes appear over detected text regions. Verify each proposal covers the burned-in annotation completely.
4. Adjust if needed — use the Redact tool to resize, move, or delete proposed regions. Add new regions for any text the OCR missed.
5. Apply redaction — click Apply & Export. All text within the redaction regions is blacked out.
6. Verify — the exported file shows black rectangles where annotations previously appeared. Original DICOM tags and non-annotated pixel regions are unchanged.

Result

OCR proposes green boxes over detected burned-in text (the region count rises above zero); exported pixels show black rectangles there while every other pixel and all DICOM tags are preserved. Manual boxes can supplement or replace the OCR proposals.