DCMTK (C++) doesn't have any significant memory leaks that I am aware of, you can take a look there to get a grasp on the amount of work you would be signing up for.

If you (or anyone) are serious about this, please for the love of God allow for multithreading (even if at the expense of efficiency), put some SIMD in there, or better yet utilize GPUs.

So much of Dicom image handling is done single thread and it's so silly.

Another startup's idea: use AI to assist programmers in rewriting medical apps in Rust.

I'd guess it's probably safer than using AI directly.