CVE-2025-53854 is a reflected cross-site scripting (XSS) vulnerability identified in MedDream PACS Premium version 7.3.6.870, a medical imaging software widely used for managing and viewing medical images. The vulnerability resides in the modifyHL7Route functionality, where user-supplied input is improperly neutralized during web page generation, allowing malicious JavaScript code to be injected and executed in the victim's browser. This reflected XSS occurs when an attacker crafts a specially designed URL containing malicious script code and convinces a user to click it. Upon visiting the URL, the injected script executes with the privileges of the web application, potentially allowing the attacker to steal session cookies, perform actions on behalf of the user, or redirect the user to malicious sites. The vulnerability does not require authentication but does require user interaction, such as clicking a link. The CVSS 3.1 base score of 6.1 reflects a medium severity, with network attack vector, low attack complexity, no privileges required, user interaction required, and a scope change. The impact affects confidentiality and integrity but not availability. No public exploits have been reported yet, but the vulnerability is publicly disclosed and should be considered a credible risk. Given the critical nature of PACS systems in healthcare, exploitation could lead to unauthorized access to sensitive patient data or manipulation of medical imaging workflows. The lack of an official patch at the time of disclosure necessitates immediate mitigation efforts by affected organizations.

For European organizations, particularly healthcare providers using MedDream PACS Premium, this vulnerability poses a significant risk to patient data confidentiality and the integrity of medical imaging workflows. Successful exploitation could enable attackers to hijack user sessions, steal sensitive health information, or conduct phishing attacks within trusted environments, potentially leading to data breaches and regulatory non-compliance under GDPR. The reflected XSS could also be leveraged as a foothold for further attacks within hospital networks. Although availability is not directly impacted, the reputational damage and operational disruptions caused by data compromise could be substantial. Given the critical role of PACS in diagnostics and treatment, any compromise could indirectly affect patient care quality. European healthcare institutions are often targeted by cybercriminals and advanced persistent threat actors, increasing the likelihood of exploitation attempts. The medium severity rating suggests moderate urgency but should not lead to complacency, especially in environments with high-value medical data.

1. Monitor MedDream vendor communications closely and apply security patches promptly once released for version 7.3.6.870 or upgrade to a fixed version. 2. Implement strict input validation and output encoding on all web application inputs, particularly in the modifyHL7Route functionality, to neutralize malicious scripts. 3. Employ web application firewalls (WAFs) with rules designed to detect and block reflected XSS attack patterns targeting PACS web interfaces. 4. Conduct user awareness training focused on recognizing and avoiding suspicious URLs and phishing attempts, especially for staff accessing PACS systems. 5. Restrict access to PACS web interfaces to trusted networks or VPNs to reduce exposure to external attackers. 6. Enable Content Security Policy (CSP) headers to limit the execution of unauthorized scripts in browsers interacting with PACS systems. 7. Regularly audit and monitor logs for unusual access patterns or attempts to exploit XSS vulnerabilities. 8. Consider implementing multi-factor authentication (MFA) to reduce the impact of session hijacking if credentials are compromised.