Vertebral Heart Score
The Vertebral Heart Score tool will start a walk-through that will guide you in drawing the correct lines to measure the Vertebral Heart Score. This is an interactive walk-through and instructions will be displayed in the Measurement Instructions.
You will first measure the long axis of the cardiac silhouette from the carina of the main stem bronchus to the apex.
Next you will measure the short axis at the widest part of the cardiac silhouette; this measurement line should be roughly perpendicular to the long axis measurement line.
To transfer these measurements to the vertebrae, click on the cranial edge of T4 and drag your cursor towards T12. You will then see two parallel measurement lines, one for each of the two measurements you have made.
You will see several lines on the shorter yellow line; click on the red dot and drag your cursor until the dots are aligned with the gap between vertebrae.
As you set the spacing of these lines to match the length of the vertebrae, you will see the function actively calculate the VHS score.

When editing annotations, you can use the Red Grab Points at the end of the lines to move the ends of the Lines. The Purple Grab Points will move the whole line. Use the Red Grab Points next to the Measurements to move the text.
Make sure to complete the entire walk-through steps prior to attempting to adjust any grab points.
This measurement is an Advanced Custom Measurement. The interactive walk-through and instructions are displayed as as Overlays on the image or in an Instruction Panel. This can be configured in the Viewer Settings.