diff --git a/.gitignore b/.gitignore
index 55e5c85..55bee24 100644
--- a/.gitignore
+++ b/.gitignore
@@ -52,5 +52,10 @@ node_modules/
 
 # VS Code
 *.code-workspace
-*~
-*.swp
+
+# Root commands
+*.cmd
+
+# vim files
+**/*~
+**/*.swp
diff --git a/packages/static-wado-creator/lib/StaticWado.js b/packages/static-wado-creator/lib/StaticWado.js
index 836bb8c..47a4571 100644
--- a/packages/static-wado-creator/lib/StaticWado.js
+++ b/packages/static-wado-creator/lib/StaticWado.js
@@ -53,14 +53,14 @@ async function cs3dThumbnail(
   dataset,
   metadata,
   transferSyntaxUid,
-  doneCallback
+  doneCallback,
 ) {
   if (!originalImageFrame) {
     throw new Error(`No originalImageFrame data available`);
   }
   if (!dataset && !metadata) {
     throw new Error(
-      `Neither dataset ${!!dataset} nor metadata ${!!metadata} available.`
+      `Neither dataset ${!!dataset} nor metadata ${!!metadata} available.`,
     );
   }
   if (isVideo(transferSyntaxUid)) {
@@ -74,7 +74,7 @@ async function cs3dThumbnail(
       originalImageFrame,
       dataset,
       metadata,
-      transferSyntaxUid
+      transferSyntaxUid,
     );
   } catch (error) {
     console.log("Error while decoding image:", error);
@@ -90,13 +90,13 @@ async function cs3dThumbnail(
   const pixelData = dicomCodec.getPixelData(
     imageFrame,
     imageInfo,
-    transferSyntaxUid
+    transferSyntaxUid,
   );
   return staticCS.getRenderedBuffer(
     transferSyntaxUid,
     pixelData,
     metadata,
-    doneCallback
+    doneCallback,
   );
 }
 
@@ -146,7 +146,7 @@ class StaticWado {
       setStudyData,
       rawDicomWriter: RawDicomWriter(this.options),
       notificationService: new NotificationService(
-        this.options.notificationDir
+        this.options.notificationDir,
       ),
       internalGenerateImage: cs3dThumbnail,
     };
@@ -184,13 +184,13 @@ class StaticWado {
     if (!this.showProgress) return;
     this.processedFiles++;
     const percentage = Math.round(
-      (this.processedFiles / this.totalFiles) * 100
+      (this.processedFiles / this.totalFiles) * 100,
     );
     const progressBar =
       "=".repeat(Math.floor(percentage / 4)) +
       "-".repeat(25 - Math.floor(percentage / 4));
     process.stdout.write(
-      `\r[${progressBar}] ${percentage}% | ${this.processedFiles}/${this.totalFiles} files`
+      `\r[${progressBar}] ${percentage}% | ${this.processedFiles}/${this.totalFiles} files`,
     );
   }
 
@@ -202,7 +202,7 @@ class StaticWado {
           if (fs.statSync(file).isDirectory()) {
             const dirFiles = fs.readdirSync(file, { recursive: true });
             this.totalFiles += dirFiles.filter(
-              (f) => !fs.statSync(path.join(file, f)).isDirectory()
+              (f) => !fs.statSync(path.join(file, f)).isDirectory(),
             ).length;
           } else {
             this.totalFiles++;
@@ -215,7 +215,7 @@ class StaticWado {
                 { FailureReason: 0xd000, TextValue: "File not DICOM" },
               ],
             },
-            file
+            file,
           );
         }
       }
@@ -297,13 +297,13 @@ class StaticWado {
         sopInstanceUid: dataSet.string("x00080018"),
         transferSyntaxUid: dataSet.string("x00020010"),
       },
-      params.file
+      params.file,
     );
 
     const targetId = transcodeId(
       id,
       this.options,
-      dataSet.uint16(Tags.RawSamplesPerPixel)
+      dataSet.uint16(Tags.RawSamplesPerPixel),
     );
 
     let bulkDataIndex = 0;
@@ -323,7 +323,7 @@ class StaticWado {
             {
               gzip: false,
               mkdir: true,
-            }
+            },
           );
           await writeStream.write(bulkData);
           await writeStream.close();
@@ -332,7 +332,7 @@ class StaticWado {
           targetId,
           _bulkDataIndex,
           bulkData,
-          options
+          options,
         );
       },
       imageFrame: async (originalImageFrame) => {
@@ -345,7 +345,7 @@ class StaticWado {
           targetId,
           originalImageFrame,
           dataSet,
-          this.options
+          this.options,
         );
 
         const lossyImage = await generateLossyImage(id, decoded, this.options);
@@ -357,7 +357,7 @@ class StaticWado {
           await this.callback.imageFrame(
             lossyImage.id,
             currentImageFrameIndex,
-            lossyImage.imageFrame
+            lossyImage.imageFrame,
           );
         }
 
@@ -369,13 +369,13 @@ class StaticWado {
             id,
             frameIndex: currentImageFrameIndex,
           },
-          this.options
+          this.options,
         );
 
         return this.callback.imageFrame(
           transcodedId,
           currentImageFrameIndex,
-          transcodedImageFrame
+          transcodedImageFrame,
         );
       },
       videoWriter: async (_dataSet) => this.callback.videoWriter(id, _dataSet),
@@ -394,14 +394,14 @@ class StaticWado {
       dataSet,
       transcodedMeta,
       this.callback,
-      this.options
+      this.options,
     );
     await thumbnailService.generateRendered(
       id,
       dataSet,
       transcodedMeta,
       this.callback,
-      this.options
+      this.options,
     );
     await this.callback.metadata(targetId, transcodedMeta);
 
@@ -418,14 +418,14 @@ class StaticWado {
     dataSet,
     metadata,
     transferSyntaxUid,
-    doneCallback
+    doneCallback,
   ) {
     return cs3dThumbnail(
       originalImageFrame,
       dataSet,
       metadata,
       transferSyntaxUid,
-      doneCallback
+      doneCallback,
     );
   }
 
@@ -464,7 +464,7 @@ class StaticWado {
       const study = await JSONReader(
         `${studiesDir}/${dir}`,
         "index.json.gz",
-        null
+        null,
       );
       if (study === null) {
         console.log("No study found in", dir);
diff --git a/packages/static-wado-creator/lib/createPart10.js b/packages/static-wado-creator/lib/createPart10.js
index 0626788..ff21172 100644
--- a/packages/static-wado-creator/lib/createPart10.js
+++ b/packages/static-wado-creator/lib/createPart10.js
@@ -18,7 +18,7 @@ const createFmi = (instance) => {
     UncompressedLEIExplicit;
   const MediaStorageSOPClassUID = Tags.getValue(
     instance,
-    Tags.MediaStorageSOPClassUID
+    Tags.MediaStorageSOPClassUID,
   );
   const SOPInstanceUID = Tags.getValue(instance, Tags.SOPInstanceUID);
   const naturalFmi = {
diff --git a/packages/static-wado-creator/lib/createThumbnail.js b/packages/static-wado-creator/lib/createThumbnail.mjs
similarity index 56%
rename from packages/static-wado-creator/lib/createThumbnail.js
rename to packages/static-wado-creator/lib/createThumbnail.mjs
index 8fdaa3d..c095e4e 100644
--- a/packages/static-wado-creator/lib/createThumbnail.js
+++ b/packages/static-wado-creator/lib/createThumbnail.mjs
@@ -1,13 +1,15 @@
-const {
+import {
   Tags,
   readBulkData,
   handleHomeRelative,
-} = require("@radicalimaging/static-wado-util");
-const dcmjs = require("dcmjs");
+  readBulkDataValue,
+  readAllBulkData,
+} from "@radicalimaging/static-wado-util";
+import dcmjs from "dcmjs";
 
-const StaticWado = require("./StaticWado");
-const adaptProgramOpts = require("./util/adaptProgramOpts");
-const WriteStream = require("./writer/WriteStream");
+import StaticWado from "./StaticWado";
+import adaptProgramOpts from "./util/adaptProgramOpts";
+import WriteStream from "./writer/WriteStream";
 
 const UncompressedLEIExplicit = "1.2.840.10008.1.2.1";
 const { DicomDict, DicomMetaDictionary } = dcmjs.data;
@@ -15,69 +17,7 @@ const { DicomDict, DicomMetaDictionary } = dcmjs.data;
 const fileMetaInformationVersionArray = new Uint8Array(2);
 fileMetaInformationVersionArray[1] = 1;
 
-const readBulkDataValue = async (studyDir, instance, value, options) => {
-  const { BulkDataURI } = value;
-  value.vr = "OB";
-  const seriesUid = Tags.getValue(instance, Tags.SeriesInstanceUID);
-  const numberOfFrames = Tags.getValue(instance, Tags.NumberOfFrames) || 1;
-  if (BulkDataURI.indexOf("/frames") !== -1) {
-    const seriesDir = `${studyDir}/series/${seriesUid}`;
-    if (options?.frame === false) {
-      return;
-    }
-    // Really only support a limited number of frames based on memory size
-    value.Value = [];
-    if (typeof options?.frame === "number") {
-      console.noQuiet("Reading frame", options.frame);
-      const bulk = await readBulkData(seriesDir, BulkDataURI, options.frame);
-      if (!bulk) {
-        return;
-      }
-      value.Value[options.frame - 1] = bulk.binaryData;
-      value.transferSyntaxUid = bulk.transferSyntaxUid;
-      value.contentType = bulk.contentType;
-      return;
-    }
-    console.noQuiet("Reading frames", 1, "...", numberOfFrames);
-    for (let frame = 1; frame <= numberOfFrames; frame++) {
-      const bulk = await readBulkData(seriesDir, BulkDataURI, frame);
-      if (!bulk) break;
-      value.Value.push(bulk.binaryData);
-      value.transferSyntaxUid = bulk.transferSyntaxUid;
-      value.contentType = bulk.contentType;
-    }
-  } else {
-    const bulk = await readBulkData(studyDir, BulkDataURI);
-    value.Value = [new ArrayBuffer(bulk.binaryData)];
-    value.contentType = bulk.contentType;
-  }
-};
-
-const readBinaryData = async (dir, instance, options = { frame: true }) => {
-  for (const tag of Object.keys(instance)) {
-    const v = instance[tag];
-    if (v.BulkDataURI) {
-      await readBulkDataValue(dir, instance, v, options);
-      continue;
-    }
-    if (!v.vr) {
-      const value0 = v.Value?.[0];
-      if (typeof value0 === "string") {
-        v.vr = "LT";
-      } else {
-        console.log("Deleting", tag, v.Value, v);
-        delete instance[tag];
-      }
-      continue;
-    }
-    if (v.vr === "SQ" && v.Values?.length) {
-      await Promise.all(v.Values.map(readBinaryData));
-      continue;
-    }
-  }
-};
-
-module.exports = async function createThumbnail(options, program) {
+export async function createThumbnail(options, program) {
   const finalOptions = adaptProgramOpts(options, {
     ...this,
     // Instance metadata is the instances/<sopUID>/metadata.gz files
@@ -141,7 +81,7 @@ module.exports = async function createThumbnail(options, program) {
       continue;
     }
 
-    await readBinaryData(dir, instance, codecOptions);
+    await readAllBulkData(dir, instance, codecOptions);
 
     const availableTransferSyntaxUID = Tags.getValue(
       instance,
@@ -178,4 +118,6 @@ module.exports = async function createThumbnail(options, program) {
     }
   }
   await Promise.all(promises);
-};
+}
+
+export default createThumbnail;
\ No newline at end of file
diff --git a/packages/static-wado-creator/lib/mkdicomwebConfig.js b/packages/static-wado-creator/lib/mkdicomwebConfig.js
index 50bac77..fc349c5 100644
--- a/packages/static-wado-creator/lib/mkdicomwebConfig.js
+++ b/packages/static-wado-creator/lib/mkdicomwebConfig.js
@@ -2,7 +2,8 @@ const ConfigPoint = require("config-point");
 const { staticWadoConfig } = require("@radicalimaging/static-wado-util");
 const createMain = require("./createMain");
 const createPart10 = require("./createPart10");
-const createThumbnail = require("./createThumbnail");
+const { createThumbnail } = require("./createThumbnail");
+const { transcodeImages } = require("./transcodeImages");
 const deleteMain = require("./deleteMain");
 const rejectMain = require("./rejectMain");
 const serverMain = require("./serverMain");
@@ -305,6 +306,12 @@ const { mkdicomwebConfig } = ConfigPoint.register({
           },
         ],
       },
+      {
+        command: "transcode",
+        main: transcodeImages,
+        helpDescription:
+          "Transcode images or create alternate representations for the specified study",
+      },
       {
         command: "instance",
         arguments: ["input"],
diff --git a/packages/static-wado-creator/lib/operation/InstanceDeduplicate.js b/packages/static-wado-creator/lib/operation/InstanceDeduplicate.js
index 575f7ab..9d743b9 100644
--- a/packages/static-wado-creator/lib/operation/InstanceDeduplicate.js
+++ b/packages/static-wado-creator/lib/operation/InstanceDeduplicate.js
@@ -44,7 +44,7 @@ async function deduplicateSingleInstance(id, imageFrame, { force }) {
       deduplicated,
       key,
       this.extractors[key],
-      TagLists.RemoveExtract
+      TagLists.RemoveExtract,
     );
     const hashKey = getValue(extracted, Tags.DeduppedHash);
     await studyData.addExtracted(this, hashKey, extracted);
@@ -99,7 +99,7 @@ const InstanceDeduplicate = (options) =>
     const deduppedInstance = await this.deduplicateSingleInstance(
       id,
       imageFrame,
-      options
+      options,
     );
     if (deduppedInstance) {
       // this refers to callee
diff --git a/packages/static-wado-creator/lib/operation/ScanStudy.js b/packages/static-wado-creator/lib/operation/ScanStudy.js
index 51afcb4..1f1ef35 100644
--- a/packages/static-wado-creator/lib/operation/ScanStudy.js
+++ b/packages/static-wado-creator/lib/operation/ScanStudy.js
@@ -32,7 +32,7 @@ function ScanStudy(options) {
     const deduplicatedInstancesPath = path.join(
       deduplicatedInstancesRoot,
       // studyInstanceUid,
-      studySubDir
+      studySubDir,
     );
     const deduplicatedPath = path.join(deduplicatedRoot, studySubDir);
     console.verbose(
@@ -40,7 +40,7 @@ function ScanStudy(options) {
       studyInstanceUid,
       studyPath,
       deduplicatedInstancesPath,
-      deduplicatedPath
+      deduplicatedPath,
     );
     return this.completeStudy.getCurrentStudyData(this, {
       studyPath,
diff --git a/packages/static-wado-creator/lib/operation/StudyData.js b/packages/static-wado-creator/lib/operation/StudyData.js
index 1872a86..f2793d9 100644
--- a/packages/static-wado-creator/lib/operation/StudyData.js
+++ b/packages/static-wado-creator/lib/operation/StudyData.js
@@ -29,7 +29,7 @@ class StudyData {
       deduplicatedPath,
       deduplicatedInstancesPath,
     },
-    { isGroup, clean, hashStudyUidPath }
+    { isGroup, clean, hashStudyUidPath },
   ) {
     this.studyInstanceUid = studyInstanceUid;
     this.studyPath = studyPath;
@@ -71,25 +71,25 @@ class StudyData {
     console.verbose("deduplicatedPath", this.deduplicatedPath);
     console.verbose(
       "deduplicatedInstancesPath",
-      this.deduplicatedInstancesPath
+      this.deduplicatedInstancesPath,
     );
 
     this.groupFiles = 0;
     const studyDeduplicated = await JSONReader(
       this.studyPath,
       "deduplicated/index.json.gz",
-      []
+      [],
     );
     const info = studyDeduplicated[0];
     if (info) {
       const hash = getValue(info, Tags.DeduppedHash);
       if (this.hashStudyUidPath) {
         console.verbose(
-          "Reading studies/<studyUIDPath>/<studyUIDSubpath>/<studyUID>/deduplicated/index.json.gz"
+          "Reading studies/<studyUIDPath>/<studyUIDSubpath>/<studyUID>/deduplicated/index.json.gz",
         );
       } else {
         console.verbose(
-          "Reading studies/<studyUID>/deduplicated/index.json.gz"
+          "Reading studies/<studyUID>/deduplicated/index.json.gz",
         );
       }
       this.readDeduplicatedData("index.json.gz", studyDeduplicated, hash);
@@ -97,7 +97,7 @@ class StudyData {
       console.log(
         "No deduplicated/index.json to read in",
         this.studyPath,
-        "/deduplicated/index.json.gz"
+        "/deduplicated/index.json.gz",
       );
     }
     if (this.deduplicatedPath) {
@@ -106,7 +106,7 @@ class StudyData {
     }
     if (this.deduplicatedInstancesPath) {
       this.instanceFiles = await this.readDeduplicated(
-        this.deduplicatedInstancesPath
+        this.deduplicatedInstancesPath,
       );
     }
   }
@@ -135,7 +135,7 @@ class StudyData {
     }
     if (this.groupFiles > 0) {
       console.verbose(
-        "dirtyMetadata::Study level deduplicated doesn't match group files"
+        "dirtyMetadata::Study level deduplicated doesn't match group files",
       );
     }
     try {
@@ -153,7 +153,7 @@ class StudyData {
     } catch (e) {
       console.verbose(
         "dirtyMetadata::Exception, assume study metadata is dirty",
-        e
+        e,
       );
       return true;
     }
@@ -215,7 +215,7 @@ class StudyData {
     const deduplicated = this.deduplicated[index];
     if (index < 0 || index >= this.deduplicated.length) {
       throw new Error(
-        `Can't read index ${index}, out of bounds [0..${this.deduplicated.length})`
+        `Can't read index ${index}, out of bounds [0..${this.deduplicated.length})`,
       );
     }
     const refs = getList(deduplicated, Tags.DeduppedRef);
@@ -237,7 +237,7 @@ class StudyData {
         console.log(
           "Already have extracted",
           hashKey,
-          getValue(item, Tags.DeduppedType)
+          getValue(item, Tags.DeduppedType),
         );
       return;
     }
@@ -384,7 +384,7 @@ class StudyData {
         console.log(
           "Skipping deleted instance",
           type,
-          getValue(seriesInstance, Tags.SeriesInstanceUID)
+          getValue(seriesInstance, Tags.SeriesInstanceUID),
         );
         continue;
       }
@@ -393,7 +393,7 @@ class StudyData {
         console.log(
           "Cant get seriesUid from",
           Tags.SeriesInstanceUID,
-          seriesInstance
+          seriesInstance,
         );
         continue;
       }
@@ -401,12 +401,12 @@ class StudyData {
         const seriesQuery = TagLists.extract(
           seriesInstance,
           "series",
-          TagLists.SeriesQuery
+          TagLists.SeriesQuery,
         );
         const seriesPath = path.join(
           this.studyPath,
           "series",
-          seriesInstanceUid
+          seriesInstanceUid,
         );
         series[seriesInstanceUid] = {
           seriesPath,
@@ -417,7 +417,7 @@ class StudyData {
       }
       series[seriesInstanceUid].instances.push(seriesInstance);
       series[seriesInstanceUid].instancesQuery.push(
-        TagLists.extract(seriesInstance, "instance", TagLists.InstanceQuery)
+        TagLists.extract(seriesInstance, "instance", TagLists.InstanceQuery),
       );
     }
 
@@ -454,7 +454,7 @@ class StudyData {
         "Wrote instances",
         seriesUid,
         "with",
-        instancesQuery.length
+        instancesQuery.length,
       );
     }
 
@@ -463,13 +463,13 @@ class StudyData {
       "Wrote series",
       this.studyInstanceUid,
       "with",
-      seriesList.length
+      seriesList.length,
     );
 
     const studyQuery = TagLists.extract(
       anInstance,
       "study",
-      TagLists.PatientStudyQuery
+      TagLists.PatientStudyQuery,
     );
     studyQuery[Tags.ModalitiesInStudy] = { Value: modalitiesInStudy, vr: "CS" };
     studyQuery[Tags.NumberOfStudyRelatedInstances] = {
@@ -492,7 +492,7 @@ class StudyData {
       Object.values(this.extractData).length,
       "extract items and",
       this.deduplicated.length,
-      "instance items"
+      "instance items",
     );
     await JSONWriter(this.studyPath, "deduplicated", [
       infoItem,
@@ -525,7 +525,7 @@ class StudyData {
     console.log(
       "Deleting instances referenced in",
       this.studyInstanceUid,
-      this.deduplicatedInstancesPath
+      this.deduplicatedInstancesPath,
     );
     const files = await this.listJsonFiles(deduplicatedDirectory);
     console.noQuiet("Deleting", files.length, "files");
@@ -558,14 +558,14 @@ class StudyData {
       Object.values(this.extractData).length,
       "extract items and",
       this.deduplicated.length,
-      "instance items"
+      "instance items",
     );
     setList(
       data,
       Tags.DeduppedRef,
       Object.keys(this.readHashes).filter(
-        () => this.deduplicatedHashes[hashValue] == undefined
-      )
+        () => this.deduplicatedHashes[hashValue] == undefined,
+      ),
     );
     const deduplicatedList = [
       data,
diff --git a/packages/static-wado-creator/lib/operation/adapter/getImageInfo.js b/packages/static-wado-creator/lib/operation/adapter/getImageInfo.js
index f752fc2..052873a 100644
--- a/packages/static-wado-creator/lib/operation/adapter/getImageInfo.js
+++ b/packages/static-wado-creator/lib/operation/adapter/getImageInfo.js
@@ -3,7 +3,8 @@ const { Tags } = require("@radicalimaging/static-wado-util");
  * Minimum image info data to be used on transcode process by dicom-codec api.
  */
 function getImageInfo(dataSet, instance) {
-  if (instance) {
+  if (instance || !dataSet.uint16) {
+    instance ||= dataSet;
     const rows = Tags.getValue(instance, Tags.Rows);
     const columns = Tags.getValue(instance, Tags.Columns);
     const bitsAllocated = Tags.getValue(instance, Tags.BitsAllocated);
diff --git a/packages/static-wado-creator/lib/operation/adapter/transcodeImage.js b/packages/static-wado-creator/lib/operation/adapter/transcodeImage.js
index 1262172..e05a6cc 100644
--- a/packages/static-wado-creator/lib/operation/adapter/transcodeImage.js
+++ b/packages/static-wado-creator/lib/operation/adapter/transcodeImage.js
@@ -135,7 +135,7 @@ function getDestinationTranscoder(id) {
   const destinationTranscoderEntry =
     transcodeDestinationMap[id] ||
     Object.values(transcodeDestinationMap).find(
-      (value) => value.transferSyntaxUid === id
+      (value) => value.transferSyntaxUid === id,
     );
   return destinationTranscoderEntry;
 }
@@ -149,7 +149,7 @@ function getDestinationTranscoder(id) {
 function getTranscoder(
   transferSyntaxUid,
   { contentType: greyContentType, colorContentType },
-  samplesPerPixel
+  samplesPerPixel,
 ) {
   const contentType =
     samplesPerPixel === 3 ? colorContentType : greyContentType;
@@ -188,7 +188,7 @@ function shouldTranscodeImageFrame(id, options, samplesPerPixel) {
     console.verbose(
       "Not transcoding because no decoder found for",
       transferSyntaxUid,
-      samplesPerPixel
+      samplesPerPixel,
     );
     return false;
   }
@@ -199,7 +199,7 @@ function shouldTranscodeImageFrame(id, options, samplesPerPixel) {
       "Not transcoding because recompress",
       recompress,
       "does not include",
-      transcoder.alias
+      transcoder.alias,
     );
     return false;
   }
@@ -241,7 +241,7 @@ function transcodeLog(options, msg, error = "") {
   }
 }
 
-function scale(imageFrame, imageInfo) {
+function scale(imageFrame, imageInfo, factor = 4) {
   const { rows, columns, bitsPerPixel, pixelRepresentation, samplesPerPixel } =
     imageInfo;
   let ArrayConstructor = Float32Array;
@@ -257,12 +257,12 @@ function scale(imageFrame, imageInfo) {
     samplesPerPixel,
   };
   const dest = {
-    rows: Math.round(rows / 4),
-    columns: Math.round(columns / 4),
+    rows: Math.round(rows / factor),
+    columns: Math.round(columns / factor),
     samplesPerPixel,
   };
   dest.pixelData = new ArrayConstructor(
-    dest.rows * dest.columns * samplesPerPixel
+    dest.rows * dest.columns * samplesPerPixel,
   );
   replicate(src, dest);
 
@@ -286,6 +286,12 @@ function scale(imageFrame, imageInfo) {
  * In either case, saves it to <sopUID>/fsiz/frameNo as multipart related
  */
 async function generateLossyImage(id, decoded, options) {
+  console.warn(
+    "generateLossyImage",
+    options.alternate,
+    options.alternateThumbnail,
+    !!decoded?.imageFrame,
+  );
   if (!options.alternate) return;
   if (!decoded?.imageFrame) return;
   console.verbose("Writing alternate thumbnail");
@@ -296,19 +302,19 @@ async function generateLossyImage(id, decoded, options) {
       ...id,
       imageFrameRootPath: id.imageFrameRootPath.replace(
         "frames",
-        options.alternateName
+        options.alternateName,
       ),
       transferSyntaxUid: transcodeDestinationMap.jhc.transferSyntaxUid,
     };
 
     let lossy = true;
-    if (options.alternateThumbnail && imageInfo.rows >= 512) {
-      const scaled = scale(imageFrame, imageInfo);
+    if (options.alternateThumbnail && imageInfo.rows >= 128) {
+      const scaled = scale(imageFrame, imageInfo, imageInfo.rows > 512 ? 4 : 2);
       if (!scaled) {
         console.log("Couldn't scale");
         return;
       }
-      imageFrame = Buffer.from(scaled.imageFrame.buffer);
+      imageFrame = scaled.imageFrame;
       imageInfo = scaled.imageInfo;
     }
 
@@ -330,13 +336,13 @@ async function generateLossyImage(id, decoded, options) {
       imageFrame,
       imageInfo,
       lossyId.transferSyntaxUid,
-      encodeOptions
+      encodeOptions,
     );
     console.verbose(
       "Encoded alternate",
       lossyId.transferSyntaxUid,
       "of size",
-      lossyEncoding.imageFrame.length
+      lossyEncoding.imageFrame.length,
     );
 
     return { id: lossyId, imageFrame: lossyEncoding.imageFrame };
@@ -346,7 +352,10 @@ async function generateLossyImage(id, decoded, options) {
 }
 
 function isPalette(dataSet) {
-  return dataSet.string(Tags.RawPhotometricInterpretation) === "PALETTE COLOR";
+  const pmi =
+    dataSet.string?.(Tags.RawPhotometricInterpretation) ||
+    Tags.getValue(dataSet, Tags.PhotometricInterpretation);
+  return pmi === "PALETTE COLOR";
 }
 
 /**
@@ -364,13 +373,17 @@ async function transcodeImageFrame(
   targetIdSrc,
   imageFrame,
   dataSet,
-  options = {}
+  options = {},
 ) {
   let targetId = targetIdSrc;
   let result = {};
 
-  const samplesPerPixel = dataSet.uint16(Tags.RawSamplesPerPixel);
-  const planarConfiguration = dataSet.uint16("x00280006");
+  const samplesPerPixel =
+    dataSet.uint16?.(Tags.RawSamplesPerPixel) ||
+    Tags.getValue(dataSet, Tags.SamplesPerPixel);
+  const planarConfiguration =
+    dataSet.uint16?.("x00280006") ||
+    Tags.getValue(dataSet, Tags.PlanarConfiguration);
   if (
     !shouldTranscodeImageFrame(id, options, samplesPerPixel) ||
     planarConfiguration === 1 ||
@@ -387,7 +400,7 @@ async function transcodeImageFrame(
   const transcoder = getTranscoder(
     id.transferSyntaxUid,
     options,
-    samplesPerPixel
+    samplesPerPixel,
   );
 
   // Don't transcode if not required
@@ -398,7 +411,7 @@ async function transcodeImageFrame(
     console.verbose(
       "Image is already in",
       targetId.transferSyntaxUid,
-      "not transcoding"
+      "not transcoding",
     );
     return {
       id,
@@ -422,54 +435,56 @@ async function transcodeImageFrame(
       case transcodeOp.transcode:
         transcodeLog(
           options,
-          `Full transcoding image from \x1b[43m${id.transferSyntaxUid}\x1b[0m to \x1b[43m${targetId.transferSyntaxUid}\x1b[0m`
+          `Full transcoding image from \x1b[43m${id.transferSyntaxUid}\x1b[0m to \x1b[43m${targetId.transferSyntaxUid}\x1b[0m`,
         );
 
         decoded = await dicomCodec.decode(
           imageFrame,
           imageInfo,
-          id.transferSyntaxUid
+          id.transferSyntaxUid,
         );
         result = await dicomCodec.encode(
           decoded.imageFrame,
           decoded.imageInfo,
           targetId.transferSyntaxUid,
-          encodeOptions
+          encodeOptions,
         );
 
         console.verbose(
           "transcoded image to",
           targetId.transferSyntaxUid,
           "of size",
-          result.imageFrame.length
+          result.imageFrame.length,
         );
         processResultMsg = `Transcoding finished`;
         break;
       case transcodeOp.encode:
         transcodeLog(
           options,
-          `Encoding image to \x1b[43m${targetId.transferSyntaxUid}\x1b[0m`
+          `Encoding image to \x1b[43m${targetId.transferSyntaxUid}\x1b[0m`,
         );
 
         result = await dicomCodec.encode(
           imageFrame,
           imageInfo,
           targetId.transferSyntaxUid,
-          encodeOptions
+          encodeOptions,
         );
+        decoded = { imageFrame, imageInfo };
 
         processResultMsg = `Encoding finished`;
         break;
       case transcodeOp.decode:
         transcodeLog(
           options,
-          `Decoding image from \x1b[43m${id.transferSyntaxUid}\x1b[0m`
+          `Decoding image from \x1b[43m${id.transferSyntaxUid}\x1b[0m`,
         );
         result = await dicomCodec.decode(
           imageFrame,
           imageInfo,
-          id.transferSyntaxUid
+          id.transferSyntaxUid,
         );
+        decoded = { imageFrame: result, imageInfo };
 
         processResultMsg = `Decoding finished`;
         break;
@@ -479,7 +494,7 @@ async function transcodeImageFrame(
 
     done = !!result.imageFrame;
   } catch (e) {
-    transcodeLog(options, "Failed to transcode image", e);
+    console.noQuiet("Failed to transcode image", e);
   }
 
   // recover transfer syntax
@@ -520,7 +535,7 @@ function transcodeId(id, options, samplesPerPixel) {
   const { transferSyntaxUid } = getTranscoder(
     id.transferSyntaxUid,
     options,
-    samplesPerPixel
+    samplesPerPixel,
   );
 
   targetId.transferSyntaxUid = transferSyntaxUid;
@@ -553,7 +568,7 @@ function transcodeMetadata(metadata, id, options) {
     Tags.setValue(
       result,
       Tags.AvailableTransferSyntaxUID,
-      transcodedId.transferSyntaxUid
+      transcodedId.transferSyntaxUid,
     );
     console.verbose("Apply available tsuid", transcodeId.transferSyntaxUid);
   }
diff --git a/packages/static-wado-creator/lib/operation/extractImageFrames.js b/packages/static-wado-creator/lib/operation/extractImageFrames.js
index 60bdbf9..9c4a2ca 100644
--- a/packages/static-wado-creator/lib/operation/extractImageFrames.js
+++ b/packages/static-wado-creator/lib/operation/extractImageFrames.js
@@ -35,20 +35,20 @@ const extractImageFrames = async (dataSet, attr, vr, callback) => {
         dataSet,
         attr,
         frameIndex,
-        framesAreFragmented
+        framesAreFragmented,
       );
       BulkDataURI = await callback.imageFrame(compressedFrame, { dataSet });
       Stats.OverallStats.add(
         "Image Write",
         `Write image frame ${frameIndex + 1}`,
-        5000
+        5000,
       );
     } else {
       const uncompressedFrame = getUncompressedImageFrame(
         dataSet,
         attr,
         frameIndex,
-        uncompressedFrameSize
+        uncompressedFrameSize,
       );
       BulkDataURI = await callback.imageFrame(uncompressedFrame, { dataSet });
     }
diff --git a/packages/static-wado-creator/lib/transcodeImages.mjs b/packages/static-wado-creator/lib/transcodeImages.mjs
new file mode 100644
index 0000000..c2a4e5d
--- /dev/null
+++ b/packages/static-wado-creator/lib/transcodeImages.mjs
@@ -0,0 +1,125 @@
+import {
+  Tags,
+  readBulkData,
+  handleHomeRelative,
+  readBulkDataValue,
+  readAllBulkData,
+} from "@radicalimaging/static-wado-util";
+import dcmjs from "dcmjs";
+
+import StaticWado from "./StaticWado";
+import { transcodeImageFrame } from "./operation/adapter/transcodeImage";
+import adaptProgramOpts from "./util/adaptProgramOpts";
+import WriteStream from "./writer/WriteStream";
+
+const UncompressedLEIExplicit = "1.2.840.10008.1.2.1";
+const { DicomDict, DicomMetaDictionary } = dcmjs.data;
+
+const fileMetaInformationVersionArray = new Uint8Array(2);
+fileMetaInformationVersionArray[1] = 1;
+
+export async function transcodeImages(options, program) {
+  const finalOptions = adaptProgramOpts(options, {
+    ...this,
+    // Instance metadata is the instances/<sopUID>/metadata.gz files
+    isInstance: false,
+    // Deduplicated data is single instance deduplicated data
+    isDeduplicate: false,
+    // Group data is the group file directories
+    isGroup: false,
+    isStudyData: false,
+    isDeleteInstances: false,
+  });
+  const importer = new StaticWado(finalOptions);
+  const studyInstanceUid = program.args[0];
+  const dir = `${importer.options.rootDir}/studies/${studyInstanceUid}`;
+  console.noQuiet("Creating alternate for", studyInstanceUid, dir);
+  const study = await importer.callback.scanStudy(studyInstanceUid);
+  const outputPath = `./studies/${studyInstanceUid}`;
+  const { sopInstanceUid, seriesInstanceUid } =
+    options;
+  const sops = sopInstanceUid ? new Set() : null;
+  if (sopInstanceUid) {
+    for (const sop of sopInstanceUid.split(",").map((s) => s.trim())) {
+      sops.add(sop);
+    }
+  }
+  const promises = [];
+
+  const writeAlternate = async (id, buffer) => {
+    console.verbose("Write alternate", id, buffer);
+    await importer.callback.thumbWriter(
+      id.sopInstanceRootPath,
+      "thumbnail",
+      buffer
+    );
+  };
+
+  // TODO - choose middle frame of multiframe and choose middle image of
+  // series for series thumbnail, and first series for study thumbnail
+  const codecOptions = { frame: 1 };
+
+  for (const sop of study.getSopUids()) {
+    if (sops && !sops.has(sop)) {
+      continue;
+    }
+    const instance = await study.recombine(sop);
+
+    if (
+      seriesInstanceUid &&
+      Tags.getValue(instance, Tags.SeriesInstanceUID) !== seriesInstanceUid
+    ) {
+      continue;
+    }
+
+    await readAllBulkData(dir, instance, codecOptions);
+
+    const availableTransferSyntaxUID = Tags.getValue(
+      instance,
+      Tags.AvailableTransferSyntaxUID
+    );
+    const pixelData = Tags.getValue(instance, Tags.PixelData);
+    if (!pixelData) {
+      console.warn("No pixel data found in instance");
+      continue;
+    }
+    const transferSyntaxUid =
+      instance[Tags.PixelData].transferSyntaxUid || availableTransferSyntaxUID;
+    const frame = Array.isArray(pixelData.Value)
+      ? pixelData.Value[0]
+      : pixelData;
+    console.verbose("Use transfer syntax uid:", transferSyntaxUid);
+    const id = importer.callback.uids({
+      studyInstanceUid,
+      seriesInstanceUid: Tags.getValue(instance, Tags.SeriesInstanceUID),
+      sopInstanceUid: sop,
+      transferSyntaxUid,
+    });
+
+    const targetId = {
+      transferSyntaxUid: "1.2.840.10008.1.2.4.70",
+    };
+    const transcodedFrame = await transcodeImageFrame(
+      id,
+      targetId,
+      frame,
+      instance,
+      { ...options, forceTranscode: true }
+    );
+    console.warn("Got transcoded frame", transcodedFrame);
+
+    // const promise = importer.callback.internalGenerateImage(
+    //   frame,
+    //   null,
+    //   instance,
+    //   id.transferSyntaxUid,
+    //   writeAlternate.bind(null, id)
+    // );
+    const promise = null;
+    console.warn("TODO - call alternate to generate alternate representation");
+    promises.push(promise);
+  }
+  await Promise.all(promises);
+}
+
+export default transcodeImages;
\ No newline at end of file
diff --git a/packages/static-wado-creator/lib/util/IdCreator.js b/packages/static-wado-creator/lib/util/IdCreator.js
index e8ca1ae..780739e 100644
--- a/packages/static-wado-creator/lib/util/IdCreator.js
+++ b/packages/static-wado-creator/lib/util/IdCreator.js
@@ -25,14 +25,14 @@ function IdCreator({
     const sopInstanceRootPath = path.join(
       seriesRootPath,
       "instances",
-      sopInstanceUid
+      sopInstanceUid,
     );
     const imageFrameRootPath = path.join(sopInstanceRootPath, "frames");
 
     const deduplicatedPath = path.join(deduplicatedRoot, studySubDir);
     const deduplicatedInstancesPath = path.join(
       deduplicatedInstancesRoot,
-      studySubDir
+      studySubDir,
     );
 
     return {
diff --git a/packages/static-wado-creator/lib/writer/CompleteStudyWriter.js b/packages/static-wado-creator/lib/writer/CompleteStudyWriter.js
index cb3ed80..84c9b50 100644
--- a/packages/static-wado-creator/lib/writer/CompleteStudyWriter.js
+++ b/packages/static-wado-creator/lib/writer/CompleteStudyWriter.js
@@ -28,12 +28,12 @@ const CompleteStudyWriter = (options) => {
         await studyData.writeDeduplicatedGroup();
         console.noQuiet(
           "Wrote updated deduplicated data for study",
-          studyData.studyInstanceUid
+          studyData.studyInstanceUid,
         );
       } else {
         console.noQuiet(
           "Not writing new deduplicated data because it is clean:",
-          studyData.studyInstanceUid
+          studyData.studyInstanceUid,
         );
         const message = {
           text: "Metadata clean, not updating",
@@ -58,7 +58,7 @@ const CompleteStudyWriter = (options) => {
       console.log("Study metadata", studyData.studyInstanceUid, "is clean.");
       delete this.studyData;
       Stats.StudyStats.summarize(
-        `Study metadata ${studyData.studyInstanceUid} has clean metadata, not writing`
+        `Study metadata ${studyData.studyInstanceUid} has clean metadata, not writing`,
       );
       return;
     }
@@ -69,7 +69,7 @@ const CompleteStudyWriter = (options) => {
     const allStudies = await JSONReader(
       options.directoryName,
       "studies/index.json.gz",
-      []
+      [],
     );
     const studyUID = Tags.getValue(studyQuery, Tags.StudyInstanceUID);
     if (!studyUID) {
@@ -77,7 +77,7 @@ const CompleteStudyWriter = (options) => {
       throw new Error("Study query has null studyUID");
     }
     const studyIndex = allStudies.findIndex(
-      (item) => Tags.getValue(item, Tags.StudyInstanceUID) == studyUID
+      (item) => Tags.getValue(item, Tags.StudyInstanceUID) == studyUID,
     );
     if (studyIndex == -1) {
       allStudies.push(studyQuery);
@@ -95,7 +95,7 @@ const CompleteStudyWriter = (options) => {
     this.success("completeStudyWriter", message);
     delete this.studyData;
     Stats.StudyStats.summarize(
-      `Wrote study metadata/query files for ${studyData.studyInstanceUid}`
+      `Wrote study metadata/query files for ${studyData.studyInstanceUid}`,
     );
   }
 
diff --git a/packages/static-wado-util/lib/dictionary/Tags.js b/packages/static-wado-util/lib/dictionary/Tags.js
index 1f1f605..eaa2402 100644
--- a/packages/static-wado-util/lib/dictionary/Tags.js
+++ b/packages/static-wado-util/lib/dictionary/Tags.js
@@ -27,7 +27,7 @@ const findPrivate = (item, tagObject, create) => {
   if (create) {
     if (!assignPosition)
       throw new Error(
-        `Couldn't find any assign positions for ${creator} ${tag} in ${item}`
+        `Couldn't find any assign positions for ${creator} ${tag} in ${item}`,
       );
     const creatorTag = `${start}00${assignPosition.toString(16)}`;
     item[creatorTag] = { Value: [creator], vr: "CS" };
@@ -137,3 +137,4 @@ Object.keys(dataDictionary).forEach((key) => {
 });
 
 module.exports = Tags;
+module.exports.Tags = Tags;
diff --git a/packages/static-wado-util/lib/index.js b/packages/static-wado-util/lib/index.js
index 49d8493..b1be81b 100644
--- a/packages/static-wado-util/lib/index.js
+++ b/packages/static-wado-util/lib/index.js
@@ -33,6 +33,7 @@ module.exports.program = program;
 module.exports.Stats = Stats;
 module.exports.getStudyUIDPathAndSubPath = require("./getStudyUIDPathAndSubPath");
 module.exports.createStudyDirectories = require("./createStudyDirectories");
+module.exports.readBulkDataValue = require("./reader/readBulkDataValue");
 
 module.exports.default = {
   ...module.exports,
diff --git a/packages/static-wado-util/lib/index.ts b/packages/static-wado-util/lib/index.ts
index efdd60d..f076631 100644
--- a/packages/static-wado-util/lib/index.ts
+++ b/packages/static-wado-util/lib/index.ts
@@ -25,6 +25,7 @@ import getStudyUIDPathAndSubPath from './getStudyUIDPathAndSubPath';
 export { program, configureProgram, configureCommands } from "./program";
 export * from "./dicomToXml";
 import createStudyDirectories from "./createStudyDirectories";
+export * from "./reader/readBulkDataValue";
 
 export {
   extractMultipart,
diff --git a/packages/static-wado-util/lib/reader/JSONReader.js b/packages/static-wado-util/lib/reader/JSONReader.js
index aac9413..c0e63d6 100644
--- a/packages/static-wado-util/lib/reader/JSONReader.js
+++ b/packages/static-wado-util/lib/reader/JSONReader.js
@@ -31,13 +31,13 @@ const JSONReader = async (dirSrc, name, def) => {
 JSONReader.readHashData = async (
   studyDir,
   hashValue,
-  extension = ".json.gz"
+  extension = ".json.gz",
 ) => {
   const hashPath = path.join(
     studyDir,
     "bulkdata",
     hashValue.substring(0, 3),
-    hashValue.substring(3, 5)
+    hashValue.substring(3, 5),
   );
   Stats.StudyStats.add("Read Hash Data", "Read hash data", 100);
   return JSONReader(hashPath, hashValue.substring(5) + extension);
diff --git a/packages/static-wado-util/lib/reader/readBulkData.js b/packages/static-wado-util/lib/reader/readBulkData.js
index f2db71b..8f95b63 100644
--- a/packages/static-wado-util/lib/reader/readBulkData.js
+++ b/packages/static-wado-util/lib/reader/readBulkData.js
@@ -111,7 +111,7 @@ const readBulkData = async (dirSrc, baseName, frame) => {
       console.noQuiet(
         "Bulkdata content type",
         `"${contentType}"`,
-        `"${transferSyntaxUid}"`
+        `"${transferSyntaxUid}"`,
       );
     }
   }
diff --git a/packages/static-wado-util/lib/reader/readBulkDataValue.mjs b/packages/static-wado-util/lib/reader/readBulkDataValue.mjs
new file mode 100644
index 0000000..b757d2d
--- /dev/null
+++ b/packages/static-wado-util/lib/reader/readBulkDataValue.mjs
@@ -0,0 +1,70 @@
+import {Tags} from "../dictionary/Tags";
+import readBulkData from "./readBulkData";
+
+export const readBulkDataValue = async (studyDir, instance, value, options) => {
+  const { BulkDataURI } = value;
+  value.vr = "OB";
+  const seriesUid = Tags.getValue(instance, Tags.SeriesInstanceUID);
+  const numberOfFrames = Tags.getValue(instance, Tags.NumberOfFrames) || 1;
+  if (BulkDataURI.indexOf("/frames") !== -1) {
+    const seriesDir = `${studyDir}/series/${seriesUid}`;
+    if (options?.frame === false) {
+      return;
+    }
+    // Really only support a limited number of frames based on memory size
+    value.Value = [];
+    if (typeof options?.frame === "number") {
+      console.noQuiet("Reading frame", options.frame);
+      const bulk = await readBulkData(seriesDir, BulkDataURI, options.frame);
+      if (!bulk) {
+        return;
+      }
+      value.Value[options.frame - 1] = bulk.binaryData;
+      value.transferSyntaxUid = bulk.transferSyntaxUid;
+      value.contentType = bulk.contentType;
+      return;
+    }
+    console.noQuiet("Reading frames", 1, "...", numberOfFrames);
+    for (let frame = 1; frame <= numberOfFrames; frame++) {
+      const bulk = await readBulkData(seriesDir, BulkDataURI, frame);
+      if (!bulk) break;
+      value.Value.push(bulk.binaryData);
+      value.transferSyntaxUid = bulk.transferSyntaxUid;
+      value.contentType = bulk.contentType;
+    }
+  } else {
+    const bulk = await readBulkData(studyDir, BulkDataURI);
+    value.Value = [new ArrayBuffer(bulk.binaryData)];
+    value.contentType = bulk.contentType;
+  }
+};
+
+export const readAllBulkData = async (
+  dir,
+  instance,
+  options = { frame: true }
+) => {
+  for (const tag of Object.keys(instance)) {
+    const v = instance[tag];
+    if (v.BulkDataURI) {
+      await readBulkDataValue(dir, instance, v, options);
+      continue;
+    }
+    if (!v.vr) {
+      const value0 = v.Value?.[0];
+      if (typeof value0 === "string") {
+        v.vr = "LT";
+      } else {
+        console.log("Deleting", tag, v.Value, v);
+        delete instance[tag];
+      }
+      continue;
+    }
+    if (v.vr === "SQ" && v.Values?.length) {
+      await Promise.all(v.Values.map(readAllBulkData));
+      continue;
+    }
+  }
+};
+
+export default readBulkDataValue;
\ No newline at end of file
diff --git a/packages/static-wado-util/lib/writer/JSONWriter.js b/packages/static-wado-util/lib/writer/JSONWriter.js
index 415845a..f0652cf 100644
--- a/packages/static-wado-util/lib/writer/JSONWriter.js
+++ b/packages/static-wado-util/lib/writer/JSONWriter.js
@@ -9,7 +9,7 @@ const JSONWriter = async (
   dirSrc,
   name,
   data,
-  options = { gzip: true, brotli: false, index: true, overwrite: true }
+  options = { gzip: true, brotli: false, index: true, overwrite: true },
 ) => {
   const fileName = options.index
     ? "index.json.gz"
@@ -19,13 +19,13 @@ const JSONWriter = async (
 
   if (options.overwrite === false && fs.existsSync(`${dirName}/${fileName}`)) {
     console.verbose(
-      `File already exists. Skipping JSON file creation at "${dirName}" named "${fileName}"`
+      `File already exists. Skipping JSON file creation at "${dirName}" named "${fileName}"`,
     );
 
     Stats.StudyStats.add(
       "JSON not written",
       `Did not write JSON file ${name}`,
-      1000
+      1000,
     );
 
     return;