DCMTK is a collection of libraries and applications implementing large parts the DICOM standard. It includes software for examining, constructing and converting DICOM image files, handling offline media, sending and receiving images over a network connection, as well as demonstrative image storage and worklist servers. DCMTK is is written in a mixture of ANSI C and C++.
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dcm4che is a collection of open source applications and utilities for the healthcare enterprise. These applications have been developed in the Java programming language for performance and portability, supporting deployment on JDK 1.4 and up.
At the core of the dcm4che project is a robust implementation of the DICOM standard. The dcm4che-1.x DICOM toolkit is used in many production applications across the world, while the current (2.x) version of the toolkit has been re-architected for high performance and flexibility.