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Medical Image QuickLook — Modern, interactive macOS Quick Look extension for medical images in NIfTI, FreeSurfer mgh, MRtrix mif, and NRRD format.

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# MIQ — Medical Image Quick Look

MIQ is a lightweight **macOS QuickLook extension** for medical volume images. Press **Space** on a supported file in Finder to instantly get an **interactive orthogonal slice view** alongside a metadata panel:

**See it in action** in the short video at the bottom of this page.

## Supported Formats

- :white_check_mark: **NIfTI-1 & NIfTI-2** — `.nii`, `.nii.gz`
- :white_check_mark: **FreeSurfer** — `.mgh`, `.mgz`, `.mgh.gz`
- :white_check_mark: **MRtrix** — `.mif`, `.mif.gz`
- :eight_spoked_asterisk: **NRRD** — `.nrrd` *(experimental, and only the single-file variant with attached header)*

All formats are supported uncompressed and gzip-compressed. The extension relies on the file extension to determine the format, so it is **important that files have the correct extensions**.

## Installation & Updates

The app and extension can be installed manually or via the package manager [Homebrew](https://brew.sh).

> The app is a universal binary for Apple Silicon (arm64) and Intel (x86_64) Macs and has been tested on macOS 14 (Sonoma), 15 (Sequoia), and 26 (Tahoe).

### Manual installation

1. 👉 **[Download the latest release (MIQ.app.zip)](https://github.com/marcoduering/MIQ/releases/latest/download/MIQ.app.zip)**
[![Latest Release](https://img.shields.io/github/v/release/marcoduering/MIQ)](https://github.com/marcoduering/MIQ/releases/latest/download/MIQ.app.zip)
2. Unzip and move **`MIQ.app`** to your **`/Applications`** folder.
3. **Open `MIQ.app`** at least once to register the Quick Look extension.
4. Press **Space** on any supported file in Finder.
5. Optional: **Customize the preview** in the MIQ app.

#### Manual update

"MIQ checks for updates, open the app occasionally to see update alerts. When a new version is available, download it and replace MIQ.app in /Applications manually."

### Installation via Homebrew

1. Install on the command line:

```bash
brew tap marcoduering/miq
brew trust --cask marcoduering/miq/miq
brew install --cask miq
```
2. **Open `MIQ.app`** (in `/Applications`) at least once to register the Quick Look extension.
3. Press **Space** on any supported file in Finder.
4. Optional: **Customize the preview** in the MIQ app.

#### Updating via Homebrew

```bash
brew update
brew upgrade --cask miq
```

## Usage

MIQ is a lightweight convenience tool for quickly inspecting medical image files directly from the Finder. It prioritizes speed and ease of use over advanced visualization, and is not meant to replace dedicated medical image viewers.

In addition to the image preview (spacebar), you can also enable **thumbnail generation** in the app so that the file icon in Finder shows an image slice.

### Customization

Use the settings (main app) to tailor the preview and thumbnails to your needs. Adjust render orientation (see explanation below), intensity scaling, label colors and the metadata panel (content and order of the items).

### Orientation

By default, MIQ displays data **as stored on disk**, without reorienting. Depending on acquisition and processing, images may appear upside down, mirrored, or rotated. This is by design. It lets you quickly inspect the raw data including its orientation. If desired, there are settings to reorient to **Neurological view** or **Radiological view**. In both reoriented conventions, sagittal displays patient anterior on the viewer's left.

### Interaction

See the **Usage** panel in the main app to learn how to control the interactive 4D view. Since version 0.5.0 MIQ supports previewing 4D data.

### Performance

Local uncompressed files are memory-mapped and load instantly. Compressed NIfTI (`.nii.gz`) is partially decompressed and loads quickly. For files on a network volume, MIQ reads only the first volume of a NIfTI from disk for the preview (the rest loads on demand when you scroll into 4D), so previews stay fast even over a slow connection. Very large `.mgz` or `.mif.gz` files may take a few seconds to load.

## Troubleshooting

### Conflicts with Other Quick Look Extensions

macOS assigns Quick Look to file types based on their file name extensions. MIQ must claim `.gz` broadly to handle `.nii.gz` and `.mif.gz` files. This can interfere with other Quick Look extensions that also manage `.gz` files (for example, extensions for compressed archives or source code).  
The most recently installed Quick Look extension should have priority, but this does not work consistently. You might need to deactivate another extension to reliably open gzip-compressed files with MIQ. This is a known limitation of how macOS Quick Look handles compound extensions like `.nii.gz`.

## Active Development

The extension is still in development. It was created with the support of AI coding agents. Please report any issues or feature suggestions using [**GitHub Issues**](https://github.com/marcoduering/MIQ/issues). If you would like to contribute, see [CONTRIBUTING.md](./CONTRIBUTING.md) or feel free to reach out.

MIQ is free and open source. If it's useful to you and you'd like to support its development, you can [**sponsor the project**](https://github.com/sponsors/marcoduering). Entirely optional, always appreciated.

## Disclaimer & License

MIQ is provided "as is" under [MIT License](./LICENSE), without warranty of any kind, express or implied. The authors and contributors accept no liability whatsoever for any direct, indirect, incidental, special, or consequential damages arising from the use or inability to use this software, including but not limited to data loss, incorrect image rendering, or any decisions made on the basis of previews generated by this tool.

> [!CAUTION]
> This software is **<ins>not</ins> a medical device and is <ins>not</ins> intended for diagnostic use**. It is a developer and researcher convenience tool only. Do not use it to make clinical decisions.

## See it in action

MIQ

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