diff --git a/extensions/cornerstone-dicom-seg/src/getSopClassHandlerModule.ts b/extensions/cornerstone-dicom-seg/src/getSopClassHandlerModule.ts
index f117b816769..6ad8f330ecc 100644
--- a/extensions/cornerstone-dicom-seg/src/getSopClassHandlerModule.ts
+++ b/extensions/cornerstone-dicom-seg/src/getSopClassHandlerModule.ts
@@ -4,8 +4,12 @@ import { metaData, eventTarget, utilities as csUtils } from '@cornerstonejs/core
 import { CONSTANTS, segmentation as cstSegmentation } from '@cornerstonejs/tools';
 import { adaptersSEG, Enums } from '@cornerstonejs/adapters';
 import { dicomLoaderService } from '@ohif/extension-cornerstone';
+import dcmjs from 'dcmjs';
 
 import { SOPClassHandlerId } from './id';
+
+const { DicomMetaDictionary } = dcmjs.data;
+const { naturalizeDataset } = DicomMetaDictionary;
 import { dicomlabToRGB } from './utils/dicomlabToRGB';
 import { getSegmentationParserType } from './utils/segmentationConfig';
 import {
@@ -460,15 +464,70 @@ async function _loadSegments({
     true;
 
   /**
-   * Check if the metadata has PerFrameFunctionalGroupsSequence.
-   * Some DICOMweb servers (like IDC's static WADO) omit this sequence from JSON metadata
-   * for large SEGs to save space. When missing, we need to fetch the full DICOM file
-   * and use the buffer-based loader which parses the complete metadata from the file.
+   * Some DICOMweb servers (e.g. IDC's static WADO) omit large sequences like
+   * PerFrameFunctionalGroupsSequence from the JSON metadata to save bandwidth.
+   * The metadata-based loader (createFromDicomSegImageId) requires this sequence
+   * to map frames to segments.
+   *
+   * Loading strategy (in order of preference):
+   * 1. If PerFrameFunctionalGroupsSequence is inline (array) → use metadata-based loader
+   * 2. If PerFrameFunctionalGroupsSequence has BulkDataURI → fetch bulk data, then use metadata-based loader
+   * 3. If bulk data fetch fails or no BulkDataURI → fall back to buffer-based loader (full Part 10 file)
    */
-  const hasPerFrameFunctionalGroups =
+  let hasPerFrameFunctionalGroups =
     Array.isArray(instance.PerFrameFunctionalGroupsSequence) &&
     instance.PerFrameFunctionalGroupsSequence.length > 0;
 
+  /**
+   * Check if PerFrameFunctionalGroupsSequence is available via bulk data.
+   * Some servers return it as { BulkDataURI: '...' } instead of inline array.
+   */
+  const perFrameValue = instance.PerFrameFunctionalGroupsSequence as
+    | unknown[]
+    | { BulkDataURI?: string; retrieveBulkData?: () => Promise<ArrayBuffer> }
+    | undefined;
+
+  if (
+    !hasPerFrameFunctionalGroups &&
+    perFrameValue &&
+    typeof perFrameValue === 'object' &&
+    !Array.isArray(perFrameValue) &&
+    (perFrameValue.BulkDataURI || typeof perFrameValue.retrieveBulkData === 'function')
+  ) {
+    try {
+      let buffer: ArrayBuffer | undefined;
+
+      if (typeof perFrameValue.retrieveBulkData === 'function') {
+        buffer = await perFrameValue.retrieveBulkData();
+      } else if (perFrameValue.BulkDataURI && dataSource.retrieve?.bulkDataURI) {
+        buffer = await dataSource.retrieve.bulkDataURI({
+          StudyInstanceUID: instance.StudyInstanceUID,
+          BulkDataURI: perFrameValue.BulkDataURI,
+        });
+      }
+
+      if (buffer && buffer.byteLength > 0) {
+        /**
+         * Parse the bulk data as JSON. The server returns the sequence as a JSON array
+         * following the DICOMweb JSON model (denaturalized form).
+         */
+        const jsonText = new TextDecoder().decode(buffer);
+        const denaturalizedSequence = JSON.parse(jsonText);
+
+        if (Array.isArray(denaturalizedSequence) && denaturalizedSequence.length > 0) {
+          /** Naturalize each item in the sequence to match OHIF's internal format */
+          const naturalizedSequence = denaturalizedSequence.map(item => naturalizeDataset(item));
+
+          /** Update the instance metadata with the fetched sequence */
+          instance.PerFrameFunctionalGroupsSequence = naturalizedSequence;
+          hasPerFrameFunctionalGroups = true;
+        }
+      }
+    } catch {
+      /** Bulk data fetch failed; fall back to buffer-based loader */
+    }
+  }
+
   let results;
   let prefetch;
 
@@ -477,13 +536,7 @@ async function _loadSegments({
      * Fallback: PerFrameFunctionalGroupsSequence is missing from metadata.
      * Fetch the full DICOM file and use createFromDICOMSegBuffer which parses
      * the complete metadata directly from the DICOM binary.
-     * This was the loading method used in OHIF 3.12 and earlier.
      */
-    log.info(
-      SEG_LOAD_LOG_PREFIX,
-      'PerFrameFunctionalGroupsSequence missing from metadata, using buffer-based loader'
-    );
-
     try {
       const arrayBuffer = await dicomLoaderService.findDicomDataPromise(
         segDisplaySet,