Pixel operations

Reorient (axial/sagittal/coronal flip)

Flip or reorient slices between axial, sagittal, and coronal planes.

Problem

A DICOM image is flipped (mirrored) or in the wrong anatomical orientation — e.g. the patient’s left appears on the right side of the screen because the scanner used a reversed coordinate system. You need to apply a flip transform to correct the orientation and produce a properly oriented derived image.

Steps

  1. Open the file (⌘O) and record the original SOP Instance UID (0008,0018) in Edit mode.

  2. Open Pixel Operations — ⌘K → “Pixel operations…”.

  3. Select Flip from the pixel operation picker.

  4. Click Apply transform — the flipped image is derived and staged in memory.

  5. Verify — filter for SOP Instance UID (0008,0018). The derived copy has a new UID starting with 2.25. (detached from the original).

Expected Result

  • A derived copy is produced with flipped pixel orientation.
  • SOP Instance UID is regenerated — a new 2.25.* UUID-derived identifier distinct from the original.
  • The original file’s UID is unchanged.
  • The flip is a simple horizontal/vertical mirror — pixel values and dimensions are preserved.