A Volumetric Presentation State (VPS) creator can create a static derived image at the same time and link it to the VPS by using the Rendered Image Reference Sequence (0070,1104). This approach yields most of the advantages of the individual formats. Additionally, it allows the static images to be used to assess the display consistency of the view.

This approach also allows for a staged review where the static image is reviewed first and the Volumetric Presentation State is only processed if further interactivity is needed.

The main disadvantage to this approach is that it may add a significant amount of data to an imaging study.