Cyble Warns of Exposed Medical Imaging, Asset Management Systems

Cyble Warns of Exposed Medical Imaging, Asset Management Systems

Cyble Warns of Exposed Medical Imaging, Asset Management Systems

Overview

Cyble’s weekly industrial control system (ICS) vulnerability report to clients warned about internet-facing medical imaging and critical infrastructure asset management systems that could be vulnerable to cyberattacks.

The report examined six ICS, operational technology (OT), and Supervisory Control and Data Acquisition (SCADA) vulnerabilities in total, but it focused on two in particular after Cyble detected web-exposed instances of the systems.

Orthanc, Trimble Cityworks Vulnerabilities Highlighted by CISA

The U.S. Cybersecurity and Infrastructure Security Agency (CISA) issued advisories alerting users to vulnerabilities in medical imaging and asset management products.

Orthanc is an open-source DICOM server used in healthcare environments for medical imaging storage and retrieval, while Trimble Cityworks is a GIS-centric asset management system used to manage all infrastructure assets for airports, utilities, municipalities, and counties.

In a February 6 ICS medical advisory, CISA said the Orthanc server prior to version 1.5.8 does not enable basic authentication by default when remote access is enabled, which could result in unauthorized access by a malicious actor. The Missing Authentication for Critical Function vulnerability, CVE-2025-0896, has been assigned a CVSS v3.1 base score of 9.8, just below the maximum score of 10.0.

Orthanc recommends that users update to the latest version or enable HTTP authentication by setting the configuration “AuthenticationEnabled”: true in the configuration file.

Cyble provided a publicly accessible search query for its ODIN vulnerability search tool, which users can use to find potentially vulnerable instances.

“This flaw requires urgent attention, as Cyble researchers have identified multiple internet-facing Orthanc instances, increasing the risk of exploitation,” the Cyble report said. “The exposure of vulnerable instances could allow unauthorized access to sensitive medical data, manipulation of imaging records, or even unauthorized control over the server. Given the high stakes in healthcare cybersecurity, immediate patching to version 1.5.8 or later, along with restricting external access, is strongly recommended to mitigate potential threats.”

CVE-2025-0994 is an 8.6-rated Deserialization of Untrusted Data in Trimble Cityworks that was reported to CISA by Trimble, which quickly patched the vulnerability and issued mitigation guidance. CISA issued an advisory on the vulnerability, which affects Cityworks versions prior to 15.8.9 and Cityworks with office companion versions prior to 23.10, and also added the vulnerability to CISA’s Known Exploited Vulnerabilities catalog.

Cyble provided an ODIN search query for users to check for exposed Cityworks instances and a hash query for ODIN subscribers.

Recommendations for Mitigating ICS Vulnerabilities

Cyble recommends several important controls for mitigating ICS vulnerabilities and improving the overall security of ICS systems. The measures include:

  1. Staying on top of security advisories and patch alerts issued by vendors and regulatory bodies like CISA. A risk-based approach to vulnerability management reduces the risk of exploitation.
  2. Implementing a Zero-Trust  Policy to minimize exposure and ensure that all internal and external network traffic is scrutinized and validated.
  3. Developing a comprehensive patch management strategy that covers inventory management, patch assessment, testing, deployment, and verification. Automating these processes can help maintain consistency and improve efficiency.
  4. Proper network segmentation can limit an attacker’s potential damage and prevent lateral movement across networks. This is particularly important for securing critical ICS assets, which should not be exposed to the Internet if possible and properly protected if remote access is essential.
  5. Conducting regular vulnerability assessments and penetration testing to identify gaps in security that might be exploited by threat actors.
  6. Establishing and maintaining an incident response plan and ensuring that it is tested and updated regularly to adapt to the latest threats.
  7. All employees, especially those working with Operational Technology (OT) systems, should be required to undergo ongoing cybersecurity training programs. The training should focus on recognizing phishing attempts, following authentication procedures, and understanding the importance of cybersecurity practices in day-to-day operations.

Conclusion

These vulnerabilities show the danger that medical and critical infrastructure system vulnerabilities can pose to patients, utilities, airports, and other sensitive environments. The organizations and CISA responded rapidly in these cases, but now users must do the same and ensure that the systems are patched and properly protected.

Regardless of the sector, staying on top of ICS vulnerabilities and applying good cybersecurity hygiene and controls can limit risk. This includes limiting internet exposure and properly protecting assets that must be accessed remotely.

To access the full report on ICS vulnerabilities observed by Cyble, along with additional insights and details, click here. By adopting a comprehensive, multi-layered security approach that includes effective vulnerability management, timely patching, and ongoing employee training, organizations can reduce their exposure to cyber threats. With the right tools and intelligence, such as those offered by Cyble, critical infrastructure can be better protected, ensuring its resilience and security in an increasingly complex cyber landscape.

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