The Annotation and Image Markup (AIM) project defines an information model and software tools to capture and create image annotations and markups using well-defined common data elements and controlled terminologies.
The AIM Toolkit includes the AIM Model, documentation, and examples. The AIM Model captures the descriptive information for an image with user-generated graphical symbols placed on the image into a single common information source. The AIM Model enhances interoperability and information exchange between imaging and health information systems. You can query AIM annotations to find images containing similar image content and correlate human image observations with other biomedical data.
The AIM Model has a corresponding C++ library, which is a reusable component that implements the AIM Model.
Downloads are listed on the main page of this AIM wiki.