A Picture Archiving and Communications System (PACS) transmits medical image information from a server (120) to a viewing workstation (101). The mode of transmission that the system uses depends on a performance metric of the network (110). If the network (110) is fast and stable, the entire DICOM image file is transmitted (203). If the network (110) is not fast and stable, one of several other modes is used to transmit the image information.