Compression of medical images has always been viewed with skepticism, since the loss of information involved is thought to affect diagnostic information. However, recent research indicates that some wavelet-based compression techniques may not effectively reduce the image quality, even when subjected to compression ratios up to 30:1. The performance of a recently designed wavelet-based adaptive vector quantization is compared with a well-known wavelet-based scalar quantization technique to demonstrate the superiority of the former technique at compression ratios higher than 30:1. The use of higher compression with high fidelity of the reconstructed images allows fast transmission of images over the Internet for prompt inspection by radiologists at remote locations in an emergency situation, while higher quality images follow in a progressive manner if desired. Such fast and progressive transmission can also be used for downloading large data sets such as the Visible Human at a quality desired by the users for research or education. This new adaptive vector quantization uses a neural networks-based clustering technique for efficient quantization of the wavelet-decomposed subimages, yielding minimal distortion in the reconstructed images undergoing high compression. Results of compression up to 100:1 are shown for 24-bit color and 8-bit monochrome medical images.