TLS can be implemented in nginx using its layer 4 capability to terminate SSL for upstream server.
I have a use case with Orthanc where a separate nginx container was used to allow DICOM on TLS. More information
here (under security).
The specific nginx configuration is
here. Check out the file
dicomtls.conf. I've tested DICOM C-STORE.
This whole example project can run on AWS so you can validate on your own.
Yi