The preliminary studies of the multimodality image registration and fusion were performed using an image fusion software and a picture archiving and communication system (PACS) to explore the methodology. Original image voluminal data were acquired with a CT scanner, MR and dual-head coincidence SPECT, respectively. The data sets from all imaging devices were queried, retrieved, transferred and accessed via DICOM PACS. The image fusion was performed at the SPECT ICON work-station, where the MIM (Medical Image Merge) fusion software was installed. The images were created by reslicing original volume on the fly. The image volumes were aligned by translation and rotation of these view ports with respect to the original volume orientation. The transparency factor and contrast were adjusted in order that both volumes can be visualized in the merged images. The image volume data of CT. MR and nuclear medicine were transferred, accessed and loaded via PACS successfully. The perfect fused images of chest CT/¹⁸F-FDG and brain MR/SPECT were obtained. These results showed that image fusion technique using PACS was feasible and practical. Further experimentation and larger validation studies were needed to explore the full potential of the clinical use.