Abstarct: In this study a 3D scalable compression method for medical images with volume of interest coding has been presented. The method is presented within the frxamework of interactive telemedicine applications, where different remote clients may access the compressed 3-D medical imaging data stored on a central server and request the transmission of different volumes of interest. The method employs the 3-D integer wavelet transform and 3-D EBCOT to create a scalable bit-stream. Optimized volume of interest coding is attained by an optimization technique that reorders the output bit-stream after encoding, so that those bits belonging to a volume of interest are decoded at the highest quality possible at any bit-rate. The bit-stream reordering procedure is baxsed on a weighting model that incorporates the position of the volume of interest and the mean energy of the wavelet coefficients. Weighting function is an exponential that causes peripherally increasing quality around the volume of interest. Results have shown that the proposed method increases reconstructed test images quality within the volume of interest about 10 dB in average, in comparison with decoding of image without using weighting model, in terms of peak signal to noise ratio (PSNR).