AMICAS, Inc.

                                                                    EXHIBIT 32.1

    CERTIFICATION PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002,
                             18 U.S.C. SECTION 1350

      In connection with this Quarterly Report on Form 10-Q of AMICAS, Inc. (the
"Company") for the three months ended September 30, 2005 (the "Report"), the
undersigned, Stephen N. Kahane, M.D., M.S., Chief Executive Officer of the
Company, and Joseph D. Hill, Chief Financial Officer of the Company, each hereby
certifies, pursuant to 18 U.S.C. Section 1350, that to his knowledge:

      (1) The Report fully complies with the requirements of Section 13(a) or
15(d) of the Securities Exchange Act of 1934; and

      (2) The information contained in the Report fairly presents, in all
material respects, the financial condition and results of operations of the
Company.

                        /s/ Stephen N. Kahane, M.D., M.S.       November 9, 2005
                        ---------------------------------                   Date
                        Stephen N. Kahane, M.D., M.S.
                        Chief Executive Officer

                        /s/ Joseph D. Hill                      November 9, 2005
                        ---------------------------------                   Date
                        Joseph D. Hill
                        Chief Financial Officer