Certain embodiments of the present invention provide methods and systems for determining a hanging protocol for display of clinical images in a study. Certain embodiments provide a machine learning hanging protocol analysis system. The example system includes an image processing module to process image data to provide one or more features. The example system includes a learning engine to receive processed image data and additional data to learn and adapt a hanging protocol for repeated use by applying one or more machine learning algorithms to the processed image data and additional data. The learning engine is to continue to refine an available selection of candidate layouts based on the processed image data and additional data to provide one or more layout choices for selection to form a hanging protocol for display of image and other data.