{
  "document": {
    "acknowledgments": [
      {
        "names": [
          "Morgen Malinoski"
        ],
        "summary": "reporting this vulnerability to CISA"
      }
    ],
    "category": "csaf_security_advisory",
    "csaf_version": "2.0",
    "distribution": {
      "text": "Disclosure is not limited",
      "tlp": {
        "label": "WHITE",
        "url": "https://www.cisa.gov/news-events/news/traffic-light-protocol-tlp-definitions-and-usage"
      }
    },
    "lang": "en-US",
    "notes": [
      {
        "category": "legal_disclaimer",
        "text": "This product is provided subject to this Notification (https://www.cisa.gov/notification) and this Privacy \u0026 Use policy (https://www.cisa.gov/privacy-policy).",
        "title": "Legal Notice and Terms of Use"
      },
      {
        "category": "summary",
        "text": "Successful exploitation of this vulnerability could allow an attacker to craft a malicious DICOM file and, if opened, could crash the application resulting in a denial-of-service condition.",
        "title": "Risk evaluation"
      },
      {
        "category": "other",
        "text": "Healthcare and Public Health",
        "title": "Critical infrastructure sectors"
      },
      {
        "category": "other",
        "text": "Worldwide",
        "title": "Countries/areas deployed"
      },
      {
        "category": "other",
        "text": "United States",
        "title": "Company headquarters location"
      },
      {
        "category": "general",
        "text": "CISA recommends users take defensive measures to minimize the risk of exploitation of this vulnerability, such as:",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "Minimize network exposure for all control system devices and/or systems, ensuring they are not accessible from the internet.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "Locate control system networks and remote devices behind firewalls and isolating them from business networks.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "When remote access is required, use more secure methods, such as Virtual Private Networks (VPNs), recognizing VPNs may have vulnerabilities and should be updated to the most current version available. Also recognize VPN is only as secure as the connected devices.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "CISA reminds organizations to perform proper impact analysis and risk assessment prior to deploying defensive measures.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "CISA also provides a section for control systems security recommended practices on the ICS webpage on cisa.gov/ics. Several CISA products detailing cyber defense best practices are available for reading and download, including Improving Industrial Control Systems Cybersecurity with Defense-in-Depth Strategies.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "CISA encourages organizations to implement recommended cybersecurity strategies for proactive defense of ICS assets.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "Additional mitigation guidance and recommended practices are publicly available on the ICS webpage at cisa.gov/ics in the technical information paper, ICS-TIP-12-146-01B--Targeted Cyber Intrusion Detection and Mitigation Strategies.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "Organizations observing suspected malicious activity should follow established internal procedures and report findings to CISA for tracking and correlation against other incidents.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "CISA also recommends users take the following measures to protect themselves from social engineering attacks:",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "Do not click web links or open attachments in unsolicited email messages.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "Refer to Recognizing and Avoiding Email Scams for more information on avoiding email scams.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "Refer to Avoiding Social Engineering and Phishing Attacks for more information on social engineering attacks.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "No known public exploitation specifically targeting this vulnerability has been reported to CISA at this time. This vulnerability is not exploitable remotely.",
        "title": "Recommended Practices"
      }
    ],
    "publisher": {
      "category": "coordinator",
      "contact_details": "central@cisa.dhs.gov",
      "name": "CISA",
      "namespace": "https://www.cisa.gov/"
    },
    "references": [
      {
        "category": "self",
        "summary": "ICS Advisory ICSMA-25-345-01 JSON",
        "url": "https://raw.githubusercontent.com/cisagov/CSAF/develop/csaf_files/OT/white/2025/icsma-25-345-01.json"
      },
      {
        "category": "self",
        "summary": "ICSA Advisory ICSMA-25-345-01 - Web Version",
        "url": "https://www.cisa.gov/news-events/ics-medical-advisories/icsma-25-345-01"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/uscert/ics/alerts/ICS-ALERT-10-301-01"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/resources-tools/resources/ics-recommended-practices"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/sites/default/files/publications/Cybersecurity_Best_Practices_for_Industrial_Control_Systems.pdf"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/topics/industrial-control-systems"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/uscert/sites/default/files/publications/emailscams0905.pdf"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/uscert/ncas/tips/ST04-014"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/news-events/ics-alerts/ics-alert-10-301-01"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/sites/default/files/recommended_practices/NCCIC_ICS-CERT_Defense_in_Depth_2016_S508C.pdf"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/news-events/news/targeted-cyber-intrusion-detection-and-mitigation-strategies-update-b"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/secure-our-world/teach-employees-avoid-phishing"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/news-events/news/avoiding-social-engineering-and-phishing-attacks"
      }
    ],
    "title": "Grassroots DICOM (GDCM)",
    "tracking": {
      "current_release_date": "2025-12-11T07:00:00.000000Z",
      "generator": {
        "date": "2025-12-11T19:16:41.081215Z",
        "engine": {
          "name": "CISA CSAF Generator",
          "version": "1.0.0"
        }
      },
      "id": "ICSMA-25-345-01",
      "initial_release_date": "2025-12-11T07:00:00.000000Z",
      "revision_history": [
        {
          "date": "2025-12-11T07:00:00.000000Z",
          "legacy_version": "Initial",
          "number": "1",
          "summary": "Initial Publication"
        }
      ],
      "status": "final",
      "version": "1"
    }
  },
  "product_tree": {
    "branches": [
      {
        "branches": [
          {
            "branches": [
              {
                "category": "product_version_range",
                "name": "\u003c=3.0.24",
                "product": {
                  "name": "Grassroots Grassroots DICOM (GDCM): \u003c=3.0.24",
                  "product_id": "CSAFPID-0001"
                }
              }
            ],
            "category": "product_name",
            "name": "Grassroots DICOM (GDCM)"
          },
          {
            "branches": [
              {
                "category": "product_version_range",
                "name": "\u003c=2.5.2",
                "product": {
                  "name": "Grassroots SimpleITK: \u003c=2.5.2",
                  "product_id": "CSAFPID-0002"
                }
              }
            ],
            "category": "product_name",
            "name": "SimpleITK"
          },
          {
            "branches": [
              {
                "category": "product_version_range",
                "name": "\u003c=4.0",
                "product": {
                  "name": "Grassroots medInria: \u003c=4.0",
                  "product_id": "CSAFPID-0003"
                }
              }
            ],
            "category": "product_name",
            "name": "medInria"
          }
        ],
        "category": "vendor",
        "name": "Grassroots"
      }
    ]
  },
  "vulnerabilities": [
    {
      "cve": "CVE-2025-11266",
      "cwe": {
        "id": "CWE-787",
        "name": "Out-of-bounds Write"
      },
      "notes": [
        {
          "category": "summary",
          "text": "An out-of-bounds write vulnerability exists in the Grassroots DICOM library (GDCM). The issue is triggered during parsing of a malformed DICOM file containing encapsulated PixelData fragments (compressed image data stored as multiple fragments). This vulnerability leads to a segmentation fault caused by an out-of-bounds memory access due to unsigned integer underflow in buffer indexing. It is exploitable via file input, simply opening a crafted malicious DICOM file is sufficient to trigger the crash, resulting in a denial-of-service condition.",
          "title": "Vulnerability Summary"
        }
      ],
      "product_status": {
        "known_affected": [
          "CSAFPID-0001",
          "CSAFPID-0002",
          "CSAFPID-0003"
        ]
      },
      "references": [
        {
          "category": "external",
          "summary": "www.cve.org",
          "url": "https://www.cve.org/CVERecord?id=CVE-2025-11266"
        },
        {
          "category": "external",
          "summary": "www.first.org",
          "url": "https://www.first.org/cvss/calculator/3.1#CVSS:3.1/AV:L/AC:L/PR:N/UI:R/S:U/C:L/I:L/A:H"
        },
        {
          "category": "external",
          "summary": "www.first.org",
          "url": "https://www.first.org/cvss/calculator/4.0#CVSS:4.0/AV:L/AC:L/AT:N/PR:N/UI:A/VC:L/VI:L/VA:H/SC:N/SI:N/SA:N"
        }
      ],
      "remediations": [
        {
          "category": "mitigation",
          "details": "The maintainer of the software recommends users update Grassroots DICOM (GDCM) to v3.2.2 or later from the main GitHub repository.",
          "product_ids": [
            "CSAFPID-0001",
            "CSAFPID-0002",
            "CSAFPID-0003"
          ],
          "url": "https://github.com/malaterre/GDCM/releases/tag/v3.2.2"
        },
        {
          "category": "vendor_fix",
          "details": "SimpleITK and medInria have both released fixes for the vulnerability.",
          "product_ids": [
            "CSAFPID-0002",
            "CSAFPID-0003"
          ]
        }
      ],
      "scores": [
        {
          "cvss_v3": {
            "baseScore": 6.6,
            "baseSeverity": "MEDIUM",
            "vectorString": "CVSS:3.1/AV:L/AC:L/PR:N/UI:R/S:U/C:L/I:L/A:H",
            "version": "3.1"
          },
          "products": [
            "CSAFPID-0001",
            "CSAFPID-0002",
            "CSAFPID-0003"
          ]
        }
      ]
    }
  ]
}