TRIAD OA, is a unified electronic clinical trials solution encompassing image collection, transfer, anonymization, re-identification, archiving and viewing of images. The system allows for enhanced annotation and markup utilities while providing flexible search and download capabilities. Built on years of experience collecting DICOM images in support of ACRIN clinical trials, TRIAD OA is designed to be fully interfaceable with major federal informatics efforts and initiatives (e.g., Cancer Biomedical Informatics Grid, caBIG).