Hanging Protocol Overview


The medical web viewer and the medical web service implement advanced support for the DICOM Hanging Protocol as defined by the DICOM standard (for more information, refer to DICOM PS3.17-V Hanging Protocols).

Unlike a presentation state (which includes manipulations specific to a particular patient’s images), a hanging protocol is simply a generic set of rules (the "protocol") describing how to lay out a set of images for viewing ("hanging", which refers to hanging the films on a lightbox).

A hanging protocol describes what to display (attributes and conditions, including modality, anatomy, laterality, procedure, and reason). It also defines how to display a set of images (window-leveling and width, rotation, tiling, etc.)


Using hanging protocols speed up diagnosis and reduce mistakes:

  • Time does not have to be spent laying out the images for viewing each time they are viewed
  • Less time is needed to find a particular feature or piece of information
    This is accomplished by providing a template for displaying images taken for imaging procedures according to a practice or user’s preference.

Using a Hanging Protocol:

There are two basic steps for using a hanging protocol:

  1. Define the hanging protocol
  2. Load the hanging protocol

Define the Hanging Protocol

In the medical web viewer, click the Compose Layout button (

compose layout button
) to open the study timeline of the patient. The study timeline displays all series available as icons at the bottom of the window. Select the desired layout and drag and drop the images onto the desired image boxes.

Perform image and layout manipulations:

  • Invert the color order, flip, rotate, or reverse the image to match the desired view

  • Align the images or lay out tile configuration

  • Set scrolling options for multi-frame images, or stack images for cine operation

  • Create orthogonal slices by clicking the MPR button

  • Turn on reference lines or synchronized stacking for volumetric studies.

Load the Hanging Protocol

Perform the following steps to load a hanging protocol:

  1. In the Search View, right-click a study to display a menu of compatible hanging protocols, and select an item from the menu to open the view with the hanging protocl applied.

  2. The medical viewer will save the hanging protocols you created to a standard DICOM dataset file, meaning you can share this hanging protocol with any other PACS server that supports this feature. Files are stored in your LEADTOOLS Storage Server manager (Storage Settings -> Files -> Hanging Protocol)

Hanging Protocol Example

  1. A hanging protocol for mammogram images, showing coronal CT scans side-by-side.

  2. A hanging protocol showing the current study, in addition to prior studies of the same patient for comparison.

  3. A hanging protocol for Chest CT, together with the relevant prior studies.

  4. A hanging protocal for a specific part of anatomy (for example, Chest), PA & Lateral (LL, RL) views, current study on the right side and a prior study on the left side.

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LEADTOOLS Medical Web Viewer

Products | Support | Contact Us | Intellectual Property Notices
© 1991-2023 LEAD Technologies, Inc. All Rights Reserved.