Benson--- Obviously I have slightly less bias than Dan, but a couple of advantages to XNAT over what I am guessing is your current system-- EXcEL spreadsheets and a huge file system with tons of DCM files
1) It's built to do what you are describing (I am a psychiatrist and that was my main initial use case)
2) As you delve deeper into the imaging data (ie. DCM stuff)... you'll realize it's a total mess and trying to build something from scratch would be overwhelming--- the idiosyncracies of the DCM "standard" is baffling
3) Good community support -- i.e. people to ask questions to who usually respond .. as well as an archive to search
4) Not many other alternatives out there that have both DICOM/ "PACS" likely functionality but ALSO allow you to tag/markup/organize the data in customizable ways----
At this point I think a "basic" XNAT install where you literally just download and install the VM image generated a couple of months ago would let you get some familiarity with uploading/organizing data...
The learning curve as Dan points out can be kind of steep-- but that's also a function of what you are trying to accomplish. If your trying to highly customize it, upload less common data types (i.e. not simple DCM data), etc. it requires finessing.
Anyway as Dan points out I'd play around with XNAT central and maybe also watch some of the videos from the past XNAT workshops.
Best of luck