DICOM provides a mechanism for supporting the use of MPEG-4 AVC/H.264 Image Compression through the Encapsulated Format. Annex A defines Non-Fragmentable and Fragmentable Encapsulated Transfer Syntaxes that reference the MPEG-4 AVC/H.264 Standard.

MPEG-4 AVC/H.264 Stereo High Profile can achieve better compression by additionally making use of prediction between the base and dependent stereoscopic views. The base view frames make use of intra and inter prediction as in MPEG-4 AVC/H.264 High Profile. This makes it possible for decoders which do not know how to decode the stereoscopic data to decode only the base view. The dependent view is encoded to make use of redundancy due to prediction based upon similarities between the base and the dependent views.

MPEG-4 AVC/H.264 Stereo High Profile makes use of the Level table A-1 of the MPEG-4 specification to set through-put limits. The properties required by the MPEG-4 AVC/H.264 Stereo High Profile Compression are identical to the properties defined in Section 8.2.8, except that Stereo Pairs Present (0022,0028) shall always be YES.

The container format for the video bit stream shall be MPEG-2 Transport Stream, a.k.a. MPEG-TS (see [ISO/IEC 13818-1]) or MPEG-4, a.k.a. MP4 container (see [ISO/IEC 14496-12] and [ISO/IEC 14496-14]). The PTS/DTS of the transport stream shall be used in the MPEG coding.

Any audio components included in the data container shall follow the constraints detailed in Section 8.2.12 Constraints for Audio Data Integration in AVC and HEVC Compressed Bit Streams.