diff --git a/extensions/cornerstone/src/tools/CalibrationLineTool.ts b/extensions/cornerstone/src/tools/CalibrationLineTool.ts
index ae914019bae..3b4a9bede0b 100644
--- a/extensions/cornerstone/src/tools/CalibrationLineTool.ts
+++ b/extensions/cornerstone/src/tools/CalibrationLineTool.ts
@@ -76,11 +76,12 @@ export function onCompletedCalibrationLine(servicesManager, csToolsEvent) {
 
   const adjustCalibration = newLength => {
     const spacingScale = newLength / length;
-    const rowSpacing = spacingScale * currentRowPixelSpacing;
-    const colSpacing = spacingScale * currentColumnPixelSpacing;
 
     // trigger resize of the viewport to adjust the world/pixel mapping
-    calibrateImageSpacing(imageId, viewport.getRenderingEngine(), rowSpacing, colSpacing);
+    calibrateImageSpacing(imageId, viewport.getRenderingEngine(), {
+      type: 'User',
+      scale: 1 / spacingScale,
+    });
   };
 
   return new Promise((resolve, reject) => {
diff --git a/extensions/cornerstone/src/utils/measurementServiceMappings/Bidirectional.ts b/extensions/cornerstone/src/utils/measurementServiceMappings/Bidirectional.ts
index a1c214e1c76..8652c7c8a2e 100644
--- a/extensions/cornerstone/src/utils/measurementServiceMappings/Bidirectional.ts
+++ b/extensions/cornerstone/src/utils/measurementServiceMappings/Bidirectional.ts
@@ -99,8 +99,7 @@ function getMappedAnnotations(annotation, displaySetService) {
     );
 
     const { SeriesNumber } = displaySet;
-    const { length, width } = targetStats;
-    const unit = 'mm';
+    const { length, width, unit } = targetStats;
 
     annotations.push({
       SeriesInstanceUID,
@@ -130,9 +129,9 @@ function _getReport(mappedAnnotations, points, FrameOfReferenceUID) {
   values.push('Cornerstone:Bidirectional');
 
   mappedAnnotations.forEach(annotation => {
-    const { length, width } = annotation;
-    columns.push(`Length (mm)`, `Width (mm)`);
-    values.push(length, width);
+    const { length, width, unit } = annotation;
+    columns.push(`Length`, `Width`, 'Unit');
+    values.push(length, width, unit);
   });
 
   if (FrameOfReferenceUID) {
@@ -162,7 +161,14 @@ function getDisplayText(mappedAnnotations, displaySet) {
   const displayText = [];
 
   // Area is the same for all series
-  const { length, width, SeriesNumber, SOPInstanceUID, frameNumber } = mappedAnnotations[0];
+  const {
+    length,
+    width,
+    unit,
+    SeriesNumber,
+    SOPInstanceUID,
+    frameNumber,
+  } = mappedAnnotations[0];
   const roundedLength = utils.roundNumber(length, 2);
   const roundedWidth = utils.roundNumber(width, 2);
 
@@ -176,8 +182,10 @@ function getDisplayText(mappedAnnotations, displaySet) {
   const instanceText = InstanceNumber ? ` I: ${InstanceNumber}` : '';
   const frameText = displaySet.isMultiFrame ? ` F: ${frameNumber}` : '';
 
-  displayText.push(`L: ${roundedLength} mm (S: ${SeriesNumber}${instanceText}${frameText})`);
-  displayText.push(`W: ${roundedWidth} mm`);
+  displayText.push(
+    `L: ${roundedLength} ${unit} (S: ${SeriesNumber}${instanceText}${frameText})`
+  );
+  displayText.push(`W: ${roundedWidth} ${unit}`);
 
   return displayText;
 }
diff --git a/extensions/cornerstone/src/utils/measurementServiceMappings/CircleROI.ts b/extensions/cornerstone/src/utils/measurementServiceMappings/CircleROI.ts
index ac784878b86..7c8f8f7cb0b 100644
--- a/extensions/cornerstone/src/utils/measurementServiceMappings/CircleROI.ts
+++ b/extensions/cornerstone/src/utils/measurementServiceMappings/CircleROI.ts
@@ -98,7 +98,7 @@ function getMappedAnnotations(annotation, DisplaySetService) {
     );
 
     const { SeriesNumber } = displaySet;
-    const { mean, stdDev, max, area, Modality, modalityUnit } = targetStats;
+    const { mean, stdDev, max, area, Modality, areaUnit, modalityUnit } = targetStats;
 
     annotations.push({
       SeriesInstanceUID,
@@ -111,6 +111,7 @@ function getMappedAnnotations(annotation, DisplaySetService) {
       stdDev,
       max,
       area,
+      areaUnit,
     });
   });
 
@@ -131,14 +132,20 @@ function _getReport(mappedAnnotations, points, FrameOfReferenceUID) {
   values.push('Cornerstone:CircleROI');
 
   mappedAnnotations.forEach(annotation => {
-    const { mean, stdDev, max, area, unit } = annotation;
+    const { mean, stdDev, max, area, unit, areaUnit } = annotation;
 
     if (!mean || !unit || !max || !area) {
       return;
     }
 
-    columns.push(`max (${unit})`, `mean (${unit})`, `std (${unit})`, `area (mm2)`);
-    values.push(max, mean, stdDev, area);
+    columns.push(
+      `max (${unit})`,
+      `mean (${unit})`,
+      `std (${unit})`,
+      'Area',
+      'Unit'
+    );
+    values.push(max, mean, stdDev, area, areaUnit);
   });
 
   if (FrameOfReferenceUID) {
@@ -168,7 +175,7 @@ function getDisplayText(mappedAnnotations, displaySet) {
   const displayText = [];
 
   // Area is the same for all series
-  const { area, SOPInstanceUID, frameNumber } = mappedAnnotations[0];
+  const { area, SOPInstanceUID, frameNumber, areaUnit } = mappedAnnotations[0];
 
   const instance = displaySet.images.find(image => image.SOPInstanceUID === SOPInstanceUID);
 
@@ -182,7 +189,7 @@ function getDisplayText(mappedAnnotations, displaySet) {
 
   // Area sometimes becomes undefined if `preventHandleOutsideImage` is off.
   const roundedArea = utils.roundNumber(area || 0, 2);
-  displayText.push(`${roundedArea} mm<sup>2</sup>`);
+  displayText.push(`${roundedArea} ${areaUnit}`);
 
   // Todo: we need a better UI for displaying all these information
   mappedAnnotations.forEach(mappedAnnotation => {
diff --git a/extensions/cornerstone/src/utils/measurementServiceMappings/EllipticalROI.ts b/extensions/cornerstone/src/utils/measurementServiceMappings/EllipticalROI.ts
index aa7e5f12977..9bcf67d5dd4 100644
--- a/extensions/cornerstone/src/utils/measurementServiceMappings/EllipticalROI.ts
+++ b/extensions/cornerstone/src/utils/measurementServiceMappings/EllipticalROI.ts
@@ -98,7 +98,7 @@ function getMappedAnnotations(annotation, displaySetService) {
     );
 
     const { SeriesNumber } = displaySet;
-    const { mean, stdDev, max, area, Modality, modalityUnit } = targetStats;
+    const { mean, stdDev, max, area, Modality, areaUnit, modalityUnit } = targetStats;
 
     annotations.push({
       SeriesInstanceUID,
@@ -107,6 +107,7 @@ function getMappedAnnotations(annotation, displaySetService) {
       frameNumber,
       Modality,
       unit: modalityUnit,
+      areaUnit,
       mean,
       stdDev,
       max,
@@ -131,14 +132,20 @@ function _getReport(mappedAnnotations, points, FrameOfReferenceUID) {
   values.push('Cornerstone:EllipticalROI');
 
   mappedAnnotations.forEach(annotation => {
-    const { mean, stdDev, max, area, unit } = annotation;
+    const { mean, stdDev, max, area, unit, areaUnit } = annotation;
 
     if (!mean || !unit || !max || !area) {
       return;
     }
 
-    columns.push(`max (${unit})`, `mean (${unit})`, `std (${unit})`, `area (mm2)`);
-    values.push(max, mean, stdDev, area);
+    columns.push(
+      `max (${unit})`,
+      `mean (${unit})`,
+      `std (${unit})`,
+      'Area',
+      'Unit'
+    );
+    values.push(max, mean, stdDev, area, areaUnit);
   });
 
   if (FrameOfReferenceUID) {
@@ -168,7 +175,7 @@ function getDisplayText(mappedAnnotations, displaySet) {
   const displayText = [];
 
   // Area is the same for all series
-  const { area, SOPInstanceUID, frameNumber } = mappedAnnotations[0];
+  const { area, SOPInstanceUID, frameNumber, areaUnit } = mappedAnnotations[0];
 
   const instance = displaySet.images.find(image => image.SOPInstanceUID === SOPInstanceUID);
 
@@ -180,9 +187,8 @@ function getDisplayText(mappedAnnotations, displaySet) {
   const instanceText = InstanceNumber ? ` I: ${InstanceNumber}` : '';
   const frameText = displaySet.isMultiFrame ? ` F: ${frameNumber}` : '';
 
-  // Area sometimes becomes undefined if `preventHandleOutsideImage` is off.
-  const roundedArea = utils.roundNumber(area || 0, 2);
-  displayText.push(`${roundedArea} mm<sup>2</sup>`);
+  const roundedArea = utils.roundNumber(area, 2);
+  displayText.push(`${roundedArea} ${areaUnit}`);
 
   // Todo: we need a better UI for displaying all these information
   mappedAnnotations.forEach(mappedAnnotation => {
diff --git a/extensions/cornerstone/src/utils/measurementServiceMappings/Length.ts b/extensions/cornerstone/src/utils/measurementServiceMappings/Length.ts
index 249522e847a..5c5072d2c19 100644
--- a/extensions/cornerstone/src/utils/measurementServiceMappings/Length.ts
+++ b/extensions/cornerstone/src/utils/measurementServiceMappings/Length.ts
@@ -32,7 +32,11 @@ const Length = {
       throw new Error('Tool not supported');
     }
 
-    const { SOPInstanceUID, SeriesInstanceUID, StudyInstanceUID } = getSOPInstanceAttributes(
+    const {
+      SOPInstanceUID,
+      SeriesInstanceUID,
+      StudyInstanceUID,
+    } = getSOPInstanceAttributes(
       referencedImageId,
       cornerstoneViewportService,
       viewportId
@@ -94,8 +98,11 @@ function getMappedAnnotations(annotation, displaySetService) {
       throw new Error('Non-acquisition plane measurement mapping not supported');
     }
 
-    const { SOPInstanceUID, SeriesInstanceUID, frameNumber } =
-      getSOPInstanceAttributes(referencedImageId);
+    const {
+      SOPInstanceUID,
+      SeriesInstanceUID,
+      frameNumber,
+    } = getSOPInstanceAttributes(referencedImageId);
 
     const displaySet = displaySetService.getDisplaySetForSOPInstanceUID(
       SOPInstanceUID,
@@ -104,8 +111,7 @@ function getMappedAnnotations(annotation, displaySetService) {
     );
 
     const { SeriesNumber } = displaySet;
-    const { length } = targetStats;
-    const unit = 'mm';
+    const { length, unit = 'mm' } = targetStats;
 
     annotations.push({
       SeriesInstanceUID,
@@ -134,9 +140,11 @@ function _getReport(mappedAnnotations, points, FrameOfReferenceUID) {
   values.push('Cornerstone:Length');
 
   mappedAnnotations.forEach(annotation => {
-    const { length } = annotation;
-    columns.push(`Length (mm)`);
+    const { length, unit } = annotation;
+    columns.push(`Length`);
     values.push(length);
+    columns.push('Unit');
+    values.push(unit);
   });
 
   if (FrameOfReferenceUID) {
@@ -166,7 +174,13 @@ function getDisplayText(mappedAnnotations, displaySet) {
   const displayText = [];
 
   // Area is the same for all series
-  const { length, SeriesNumber, SOPInstanceUID, frameNumber } = mappedAnnotations[0];
+  const {
+    length,
+    SeriesNumber,
+    SOPInstanceUID,
+    frameNumber,
+    unit,
+  } = mappedAnnotations[0];
 
   const instance = displaySet.images.find(image => image.SOPInstanceUID === SOPInstanceUID);
 
@@ -182,7 +196,9 @@ function getDisplayText(mappedAnnotations, displaySet) {
     return displayText;
   }
   const roundedLength = utils.roundNumber(length, 2);
-  displayText.push(`${roundedLength} mm (S: ${SeriesNumber}${instanceText}${frameText})`);
+  displayText.push(
+    `${roundedLength} ${unit} (S: ${SeriesNumber}${instanceText}${frameText})`
+  );
 
   return displayText;
 }
diff --git a/extensions/cornerstone/src/utils/measurementServiceMappings/RectangleROI.ts b/extensions/cornerstone/src/utils/measurementServiceMappings/RectangleROI.ts
index 035b87457c6..567badd1d2d 100644
--- a/extensions/cornerstone/src/utils/measurementServiceMappings/RectangleROI.ts
+++ b/extensions/cornerstone/src/utils/measurementServiceMappings/RectangleROI.ts
@@ -25,7 +25,11 @@ const RectangleROI = {
       throw new Error('Tool not supported');
     }
 
-    const { SOPInstanceUID, SeriesInstanceUID, StudyInstanceUID } = getSOPInstanceAttributes(
+    const {
+      SOPInstanceUID,
+      SeriesInstanceUID,
+      StudyInstanceUID,
+    } = getSOPInstanceAttributes(
       referencedImageId,
       CornerstoneViewportService,
       viewportId
@@ -88,8 +92,11 @@ function getMappedAnnotations(annotation, DisplaySetService) {
       throw new Error('Non-acquisition plane measurement mapping not supported');
     }
 
-    const { SOPInstanceUID, SeriesInstanceUID, frameNumber } =
-      getSOPInstanceAttributes(referencedImageId);
+    const {
+      SOPInstanceUID,
+      SeriesInstanceUID,
+      frameNumber,
+    } = getSOPInstanceAttributes(referencedImageId);
 
     const displaySet = DisplaySetService.getDisplaySetForSOPInstanceUID(
       SOPInstanceUID,
@@ -98,7 +105,7 @@ function getMappedAnnotations(annotation, DisplaySetService) {
     );
 
     const { SeriesNumber } = displaySet;
-    const { mean, stdDev, max, area, Modality, modalityUnit } = targetStats;
+    const { mean, stdDev, max, area, Modality, modalityUnit, areaUnit } = targetStats;
 
     annotations.push({
       SeriesInstanceUID,
@@ -111,6 +118,7 @@ function getMappedAnnotations(annotation, DisplaySetService) {
       stdDev,
       max,
       area,
+      areaUnit,
     });
   });
 
@@ -131,14 +139,14 @@ function _getReport(mappedAnnotations, points, FrameOfReferenceUID) {
   values.push('Cornerstone:RectangleROI');
 
   mappedAnnotations.forEach(annotation => {
-    const { mean, stdDev, max, area, unit } = annotation;
+    const { mean, stdDev, max, area, unit, areaUnit } = annotation;
 
     if (!mean || !unit || !max || !area) {
       return;
     }
 
-    columns.push(`max (${unit})`, `mean (${unit})`, `std (${unit})`, `area (mm2)`);
-    values.push(max, mean, stdDev, area);
+    columns.push(`Maximum`, `Mean`, `Std Dev`, 'Pixel Unit', `Area`, 'Unit');
+    values.push(max, mean, stdDev, unit, area, areaUnit);
   });
 
   if (FrameOfReferenceUID) {
@@ -168,7 +176,7 @@ function getDisplayText(mappedAnnotations, displaySet) {
   const displayText = [];
 
   // Area is the same for all series
-  const { area, SOPInstanceUID, frameNumber } = mappedAnnotations[0];
+  const { area, SOPInstanceUID, frameNumber, areaUnit } = mappedAnnotations[0];
 
   const instance = displaySet.images.find(image => image.SOPInstanceUID === SOPInstanceUID);
 
@@ -182,7 +190,7 @@ function getDisplayText(mappedAnnotations, displaySet) {
 
   // Area sometimes becomes undefined if `preventHandleOutsideImage` is off.
   const roundedArea = utils.roundNumber(area || 0, 2);
-  displayText.push(`${roundedArea} mm<sup>2</sup>`);
+  displayText.push(`${roundedArea} ${areaUnit}`);
 
   // Todo: we need a better UI for displaying all these information
   mappedAnnotations.forEach(mappedAnnotation => {
diff --git a/platform/core/src/classes/MetadataProvider.js b/platform/core/src/classes/MetadataProvider.ts
similarity index 89%
rename from platform/core/src/classes/MetadataProvider.js
rename to platform/core/src/classes/MetadataProvider.ts
index 41e6cdbc6db..7b59c3ebd68 100644
--- a/platform/core/src/classes/MetadataProvider.js
+++ b/platform/core/src/classes/MetadataProvider.ts
@@ -68,7 +68,7 @@ class MetadataProvider {
 
     if (!instance) {
       return;
-    }
+  }
 
     return (frameNumber && combineFrameInstance(frameNumber, instance)) || instance;
   }
@@ -114,8 +114,20 @@ class MetadataProvider {
     return this._getCornerstoneDICOMImageLoaderTag(naturalizedTagOrWADOImageLoaderTag, instance);
   }
 
+  /**
+   * Adds a new handler for the given tag.  The handler will be provided an
+   * instance object that it can read values from.
+   */
+  public addHandler(
+    wadoImageLoaderTag: string,
+    handler
+  ) {
+    WADO_IMAGE_LOADER[wadoImageLoaderTag] = handler;
+  }
+
   _getCornerstoneDICOMImageLoaderTag(wadoImageLoaderTag, instance) {
-    let metadata;
+    let metadata = WADO_IMAGE_LOADER[wadoImageLoaderTag]?.(instance);
+    if (metadata) return metadata;
 
     switch (wadoImageLoaderTag) {
       case WADO_IMAGE_LOADER_TAGS.GENERAL_SERIES_MODULE:
@@ -153,45 +165,6 @@ class MetadataProvider {
           patientSex: instance.PatientSex,
         };
         break;
-      case WADO_IMAGE_LOADER_TAGS.IMAGE_PLANE_MODULE:
-        const { ImageOrientationPatient } = instance;
-
-        // Fallback for DX images.
-        // TODO: We should use the rest of the results of this function
-        // to update the UI somehow
-        const { PixelSpacing } = getPixelSpacingInformation(instance);
-
-        let rowPixelSpacing;
-        let columnPixelSpacing;
-
-        let rowCosines;
-        let columnCosines;
-
-        if (PixelSpacing) {
-          rowPixelSpacing = PixelSpacing[0];
-          columnPixelSpacing = PixelSpacing[1];
-        }
-
-        if (ImageOrientationPatient) {
-          rowCosines = ImageOrientationPatient.slice(0, 3);
-          columnCosines = ImageOrientationPatient.slice(3, 6);
-        }
-
-        metadata = {
-          frameOfReferenceUID: instance.FrameOfReferenceUID,
-          rows: toNumber(instance.Rows),
-          columns: toNumber(instance.Columns),
-          imageOrientationPatient: toNumber(ImageOrientationPatient),
-          rowCosines: toNumber(rowCosines || [0, 1, 0]),
-          columnCosines: toNumber(columnCosines || [0, 0, -1]),
-          imagePositionPatient: toNumber(instance.ImagePositionPatient || [0, 0, 0]),
-          sliceThickness: toNumber(instance.SliceThickness),
-          sliceLocation: toNumber(instance.SliceLocation),
-          pixelSpacing: toNumber(PixelSpacing || 1),
-          rowPixelSpacing: toNumber(rowPixelSpacing || 1),
-          columnPixelSpacing: toNumber(columnPixelSpacing || 1),
-        };
-        break;
       case WADO_IMAGE_LOADER_TAGS.IMAGE_PIXEL_MODULE:
         metadata = {
           samplesPerPixel: toNumber(instance.SamplesPerPixel),
@@ -484,11 +457,54 @@ const metadataProvider = new MetadataProvider();
 
 export default metadataProvider;
 
+const WADO_IMAGE_LOADER = {
+  imagePlaneModule: instance => {
+    const { ImageOrientationPatient } = instance;
+
+    // Fallback for DX images.
+    // TODO: We should use the rest of the results of this function
+    // to update the UI somehow
+    const { PixelSpacing } = getPixelSpacingInformation(instance);
+
+    let rowPixelSpacing;
+    let columnPixelSpacing;
+
+    let rowCosines;
+    let columnCosines;
+
+    if (PixelSpacing) {
+      rowPixelSpacing = PixelSpacing[0];
+      columnPixelSpacing = PixelSpacing[1];
+    }
+
+    if (ImageOrientationPatient) {
+      rowCosines = ImageOrientationPatient.slice(0, 3);
+      columnCosines = ImageOrientationPatient.slice(3, 6);
+    }
+
+    return {
+      frameOfReferenceUID: instance.FrameOfReferenceUID,
+      rows: toNumber(instance.Rows),
+      columns: toNumber(instance.Columns),
+      imageOrientationPatient: toNumber(ImageOrientationPatient),
+      rowCosines: toNumber(rowCosines || [0, 1, 0]),
+      columnCosines: toNumber(columnCosines || [0, 0, -1]),
+      imagePositionPatient: toNumber(
+        instance.ImagePositionPatient || [0, 0, 0]
+      ),
+      sliceThickness: toNumber(instance.SliceThickness),
+      sliceLocation: toNumber(instance.SliceLocation),
+      pixelSpacing: toNumber(PixelSpacing || 1),
+      rowPixelSpacing: rowPixelSpacing ? toNumber(rowPixelSpacing) : null,
+      columnPixelSpacing: columnPixelSpacing ? toNumber(columnPixelSpacing) : null,
+    };
+  },
+};
+
 const WADO_IMAGE_LOADER_TAGS = {
   // dicomImageLoader specific
   GENERAL_SERIES_MODULE: 'generalSeriesModule',
   PATIENT_STUDY_MODULE: 'patientStudyModule',
-  IMAGE_PLANE_MODULE: 'imagePlaneModule',
   IMAGE_PIXEL_MODULE: 'imagePixelModule',
   VOI_LUT_MODULE: 'voiLutModule',
   MODALITY_LUT_MODULE: 'modalityLutModule',
diff --git a/platform/core/src/utils/roundNumber.js b/platform/core/src/utils/roundNumber.js
index a441225da50..be76c7edea3 100644
--- a/platform/core/src/utils/roundNumber.js
+++ b/platform/core/src/utils/roundNumber.js
@@ -1,9 +1,34 @@
 /**
- * @param {string | number} value
- * @param {number} decimals
+ * Truncates decimal points to that there is at least 1+precision significant
+ * digits.
+ *
+ * For example, with the default precision 2 (3 significant digits)
+ * * Values larger than 100 show no information after the decimal point
+ * * Values between 10 and 99 show 1 decimal point
+ * * Values between 1 and 9 show 2 decimal points
+ *
+ * @param value - to return a fixed measurement value from
+ * @param precision - defining how many digits after 1..9 are desired
  */
-function _round(value, decimals) {
-  return Number(value).toFixed(decimals);
+function roundNumber(value: string | number, precision = 2): string {
+  if (value === undefined || value === null || value === '') return 'NaN';
+  value = Number(value);
+  if (value < 0.0001) return `${value}`;
+  const fixedPrecision =
+    value >= 100
+      ? precision - 2
+      : value >= 10
+        ? precision - 1
+        : value >= 1
+          ? precision
+          : value >= 0.1
+            ? precision + 1
+            : value >= 0.01
+              ? precision + 2
+              : value >= 0.001
+                ? precision + 3
+                : precision + 4;
+  return value.toFixed(fixedPrecision);
 }
 
-export default _round;
+export default roundNumber;