The responses from 26 different countries showed significant differences. 62% of the responses from DMS users came from Western Europe, 38% from Eastern Europe (Fig. 1). For IS facilities, 51% of the responses came from MPEs and 26% from radiologists. For Non Imaging Stars facilities (NIS), 16% of the responses came from MPEs and 72% from radiologists, showing that IS have higher availability and involvement of MPEs. DMS users reported examination frequencies ranging from 100,000 to over 300,000 per year, non-DMS users from 10,000 to 30,000 (Fig. 2). The main problems reported are modality interfaces, protocol names, clinical workflow integration and IT support (Fig. 3) [5]. The analysis of answers in this publication shows considerable heterogeneity about the parameters mentioned and a bias about the frequency of answers from DMS users and DMS-non-users.