Thanks a lot Henrik, it is very helpful and interesting. I am able to extract the boundary of the Dicom Format image.
With img being the top image you can try things like:
img
Binarize[img, 0.95] DeleteSmallComponents[%] ColorNegate[DeleteSmallComponents[ColorNegate[%]]] MorphologicalPerimeter[%] ComponentMeasurements[%, "Contours"]
Thanks so much for helping me with this.