diff --git a/packages/core/src/utilities/generateVolumePropsFromImageIds.ts b/packages/core/src/utilities/generateVolumePropsFromImageIds.ts
index 814465ffa6..1315c9d51c 100644
--- a/packages/core/src/utilities/generateVolumePropsFromImageIds.ts
+++ b/packages/core/src/utilities/generateVolumePropsFromImageIds.ts
@@ -132,6 +132,7 @@ function _determineDataType(
       return 'Uint8Array';
 
     case 16:
+    case 12:
       // Temporary fix for 16 bit images to use Float32
       if (canRenderFloat && floatAfterScale) {
         return 'Float32Array';
diff --git a/packages/dicomImageLoader/src/imageLoader/wadouri/getUncompressedImageFrame.ts b/packages/dicomImageLoader/src/imageLoader/wadouri/getUncompressedImageFrame.ts
index acf7087675..afc0857fd6 100644
--- a/packages/dicomImageLoader/src/imageLoader/wadouri/getUncompressedImageFrame.ts
+++ b/packages/dicomImageLoader/src/imageLoader/wadouri/getUncompressedImageFrame.ts
@@ -59,6 +59,36 @@ function getUncompressedImageFrame(
     return new Uint8Array(
       dataSet.byteArray.buffer.slice(frameOffset, frameOffset + pixelsPerFrame)
     );
+  } else if (bitsAllocated === 12) {
+    // Packed 12-bit: 2 pixels = 3 bytes
+    const bytesPerFrame = Math.ceil((pixelsPerFrame * 12) / 8);
+    frameOffset = pixelDataOffset + frameIndex * bytesPerFrame;
+
+    if (frameOffset + bytesPerFrame > dataSet.byteArray.length) {
+      throw new Error('frame exceeds size of pixelData');
+    }
+
+    const pixelData = new Uint16Array(pixelsPerFrame);
+    let byteOffset = frameOffset;
+    let pixelIndex = 0;
+
+    while (pixelIndex < pixelsPerFrame) {
+      const byte0 = dataSet.byteArray[byteOffset++] || 0;
+      const byte1 = dataSet.byteArray[byteOffset++] || 0;
+      const byte2 = dataSet.byteArray[byteOffset++] || 0;
+
+      // First pixel: lower 12 bits from bytes 0-1
+      // Byte0: bits 0-7, Byte1 bits 0-3 (lower nibble)
+      pixelData[pixelIndex++] = byte0 | ((byte1 & 0x0f) << 8);
+
+      // Second pixel: upper 12 bits from bytes 1-2
+      // Byte1 bits 4-7 (upper nibble), Byte2: bits 0-7
+      if (pixelIndex < pixelsPerFrame) {
+        pixelData[pixelIndex++] = (byte1 >> 4) | (byte2 << 4);
+      }
+    }
+
+    return new Uint8Array(pixelData.buffer);
   } else if (bitsAllocated === 16) {
     frameOffset = pixelDataOffset + frameIndex * pixelsPerFrame * 2;
     if (frameOffset >= dataSet.byteArray.length) {
diff --git a/packages/dicomImageLoader/src/shared/decoders/decodeBigEndian.ts b/packages/dicomImageLoader/src/shared/decoders/decodeBigEndian.ts
index cd250d76ea..3ffe53d02e 100644
--- a/packages/dicomImageLoader/src/shared/decoders/decodeBigEndian.ts
+++ b/packages/dicomImageLoader/src/shared/decoders/decodeBigEndian.ts
@@ -10,7 +10,7 @@ async function decodeBigEndian(
   imageFrame: Types.IImageFrame,
   pixelData: ByteArray
 ): Promise<Types.IImageFrame> {
-  if (imageFrame.bitsAllocated === 16) {
+  if (imageFrame.bitsAllocated === 16 || imageFrame.bitsAllocated === 12) {
     let arrayBuffer = pixelData.buffer;
 
     let offset = pixelData.byteOffset;
diff --git a/packages/dicomImageLoader/src/shared/decoders/decodeJPEGBaseline12Bit-js.ts b/packages/dicomImageLoader/src/shared/decoders/decodeJPEGBaseline12Bit-js.ts
index edaf33548e..ff06db95f2 100644
--- a/packages/dicomImageLoader/src/shared/decoders/decodeJPEGBaseline12Bit-js.ts
+++ b/packages/dicomImageLoader/src/shared/decoders/decodeJPEGBaseline12Bit-js.ts
@@ -47,7 +47,10 @@ async function decodeJPEGBaseline12BitAsync(
     imageFrame.pixelData = jpeg.getData(imageFrame.columns, imageFrame.rows);
 
     return imageFrame;
-  } else if (imageFrame.bitsAllocated === 16) {
+  } else if (
+    imageFrame.bitsAllocated === 16 ||
+    imageFrame.bitsAllocated === 12
+  ) {
     imageFrame.pixelData = jpeg.getData16(imageFrame.columns, imageFrame.rows);
 
     return imageFrame;
diff --git a/packages/dicomImageLoader/src/shared/decoders/decodeJPEGLossless.ts b/packages/dicomImageLoader/src/shared/decoders/decodeJPEGLossless.ts
index 69fdc88a68..cc497f120c 100644
--- a/packages/dicomImageLoader/src/shared/decoders/decodeJPEGLossless.ts
+++ b/packages/dicomImageLoader/src/shared/decoders/decodeJPEGLossless.ts
@@ -48,7 +48,7 @@ async function decodeJPEGLossless(
   );
 
   if (imageFrame.pixelRepresentation === 0) {
-    if (imageFrame.bitsAllocated === 16) {
+    if (imageFrame.bitsAllocated === 16 || imageFrame.bitsAllocated === 12) {
       imageFrame.pixelData = new Uint16Array(decompressedData.buffer);
 
       return imageFrame;
diff --git a/packages/dicomImageLoader/src/shared/decoders/decodeLittleEndian.ts b/packages/dicomImageLoader/src/shared/decoders/decodeLittleEndian.ts
index 7d763c649d..665de4dc6e 100644
--- a/packages/dicomImageLoader/src/shared/decoders/decodeLittleEndian.ts
+++ b/packages/dicomImageLoader/src/shared/decoders/decodeLittleEndian.ts
@@ -10,7 +10,7 @@ async function decodeLittleEndian(
   let offset = pixelData.byteOffset;
   const length = pixelData.length;
 
-  if (imageFrame.bitsAllocated === 16) {
+  if (imageFrame.bitsAllocated === 16 || imageFrame.bitsAllocated === 12) {
     // if pixel data is not aligned on even boundary, shift it so we can create the 16 bit array
     // buffers on it
     if (offset % 2) {
diff --git a/packages/dicomImageLoader/src/shared/decoders/decodeRLE.ts b/packages/dicomImageLoader/src/shared/decoders/decodeRLE.ts
index 82737970ee..cf8ae83b3c 100644
--- a/packages/dicomImageLoader/src/shared/decoders/decodeRLE.ts
+++ b/packages/dicomImageLoader/src/shared/decoders/decodeRLE.ts
@@ -13,6 +13,8 @@ async function decodeRLE(
     return decode8(imageFrame, pixelData);
   } else if (imageFrame.bitsAllocated === 16) {
     return decode16(imageFrame, pixelData);
+  } else if (imageFrame.bitsAllocated === 12) {
+    return decode12(imageFrame, pixelData);
   }
 
   throw new Error('unsupported pixel format for RLE');
@@ -172,4 +174,54 @@ function decode16(imageFrame: Types.IImageFrame, pixelData: ByteArray) {
   return imageFrame;
 }
 
+function decode12(imageFrame: Types.IImageFrame, pixelData: ByteArray) {
+  const frameData = pixelData;
+  const frameSize = imageFrame.rows * imageFrame.columns;
+  const outFrame = new ArrayBuffer(frameSize * imageFrame.samplesPerPixel * 2);
+
+  const header = new DataView(frameData.buffer, frameData.byteOffset);
+  const data = new Int8Array(frameData.buffer, frameData.byteOffset);
+  const out = new Int8Array(outFrame);
+
+  const numSegments = header.getInt32(0, true);
+
+  for (let s = 0; s < numSegments; ++s) {
+    let outIndex = 0;
+    const highByte = s === 0 ? 1 : 0;
+
+    let inIndex = header.getInt32((s + 1) * 4, true);
+
+    let maxIndex = header.getInt32((s + 2) * 4, true);
+
+    if (maxIndex === 0) {
+      maxIndex = frameData.length;
+    }
+
+    while (inIndex < maxIndex) {
+      const n = data[inIndex++];
+
+      if (n >= 0 && n <= 127) {
+        for (let i = 0; i < n + 1 && outIndex < frameSize; ++i) {
+          out[outIndex * 2 + highByte] = data[inIndex++];
+          outIndex++;
+        }
+      } else if (n <= -1 && n >= -127) {
+        const value = data[inIndex++];
+
+        for (let j = 0; j < -n + 1 && outIndex < frameSize; ++j) {
+          out[outIndex * 2 + highByte] = value;
+          outIndex++;
+        }
+      }
+    }
+  }
+  if (imageFrame.pixelRepresentation === 0) {
+    imageFrame.pixelData = new Uint16Array(outFrame);
+  } else {
+    imageFrame.pixelData = new Int16Array(outFrame);
+  }
+
+  return imageFrame;
+}
+
 export default decodeRLE;