DICOM @ OFFIS

ok, sorry I misunderstood. I was thinking you call this after the loop. How do you write that file? Because maybe you're writing on a text mode based stream and therefore each single 0A becomes a 0D 0A sequence. You should try to call the m_fileformat->print(textoutputstream/e.g. COUT, ...) function...

Are you sure that subItem[iPdFile] is valid? You have a loop over iPlugin at least overwriting the first valueset of the array. And if you don't loop again over iPdFile it has value 5 which is invalid. subItem[5] is in fact one of item or elementPDNum due to memory alignment (probably elementPDNum).

There is a misunderstanding of PixelPadding.
The PixelPadding is the value which is used for pixel outside of the recorded area, e.g. to fill up a circular to a rectangular area.

In other words, pixel having the PixelPadding value should be drawn transparent or in background color.