CVE-2025-11266 Grassroots CVE debrief

Who should care

Teams running software that embeds or depends on GDCM, including SimpleITK and medInria deployments, should care most. This is especially relevant for imaging workflows that accept DICOM files from outside the organization or from less-trusted sources.

Technical summary

The source advisory describes an out-of-bounds write in the Grassroots DICOM library during parsing of malformed DICOM files containing encapsulated PixelData fragments. The failure mode is an unsigned integer underflow in buffer indexing, which can produce an out-of-bounds memory access and segmentation fault. The issue is exploitable through file input alone; simply opening a crafted malicious DICOM file is sufficient to trigger the crash. The supplied CVSS v3.1 vector is AV:L/AC:L/PR:N/UI:R/S:U/C:L/I:L/A:H, and the score is 6.6 (Medium).

Defensive priority

Medium. The issue is limited to file-triggered denial of service in the supplied advisory, but it affects parsing of untrusted medical imaging content and can be triggered by opening a malicious file.

Recommended defensive actions

• Update Grassroots DICOM (GDCM) to v3.2.2 or later, as recommended by the maintainer.
• Apply the released fixes for downstream products that embed or package the library, including SimpleITK and medInria.
• Treat DICOM files from untrusted sources as potentially malicious until patched versions are deployed.
• Prioritize remediation in any workflow where users open externally supplied imaging files.

Evidence notes

The supplied CISA CSAF advisory (ICSMA-25-345-01) states that the flaw is an out-of-bounds write in GDCM triggered while parsing malformed DICOM files with encapsulated PixelData fragments, and that opening a crafted file can cause a segmentation fault and denial of service. The advisory recommends updating GDCM to v3.2.2 or later and notes that SimpleITK and medInria have released fixes. The CVE and source advisory were both published on 2025-12-11 in the supplied data. No CISA KEV entry is present in the supplied enrichment.

Sources and references

Methodology and review provenance

AI-assisted synthesis based on stored public vulnerability evidence. System validation, approval state, and publication status do not by themselves establish human review of this revision. PatchSiren helps prioritize defensive review and does not prove exposure or remediation on any system.