Image transformations
You can change the positioning of an image. In the toolbar, clickImage control and select Image transformations from the drop-down list.
You can perform the following transformations:
Rotate counter clockwise
Rotate Clockwise
Flip Horizontal
Flip Vertical
Align left
Align top
Align right
Align bottom
Align center
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Tip:

To rotate the image you can use the following short cut: CTRL + SHIFT (keyboard) + scroll (mouse wheel)
Save presentation state:
A Presentation State is an independent DICOM SOP Instance that contains information on how a particular image should be displayed. This is used when a correction needs to be made for an image or multiple images. For example: Flipping or rotating an image.
When the correction is applied, click Save presentation state.
The last saved presentation state will be displayed.
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Note:

Only source admins or users with the permission SavePresentationState can save a presentation state.