Starviewer and its comparison with other open-source DICOM viewers using a novel hierarchical evaluation framework

•Starviewer a multi-platform open-source DICOM viewer for basic and advanced daily practice is presented.•An evaluation framework which can be user-configured and adapted to any scenario is presented.•A very fine-grained set of criteria to evaluate DICOM viewers is defined.•Evaluation of five open-source viewers: Ginkgo CADx, Horos, Starviewer, medInria and Weasis.•Horos is the best viewer overall, and Starviewer takes a second position.