diff --git a/packages/core/src/RenderingEngine/StackViewport.ts b/packages/core/src/RenderingEngine/StackViewport.ts
index c9f1c8ca8..cb58ff1d4 100644
--- a/packages/core/src/RenderingEngine/StackViewport.ts
+++ b/packages/core/src/RenderingEngine/StackViewport.ts
@@ -1309,8 +1309,8 @@ class StackViewport extends Viewport implements IStackViewport {
     const dataType = imageData.getPointData().getScalars().getDataType();
 
     // using epsilon comparison for float numbers comparison.
-    const isSameXSpacing = isEqual(xSpacing, image.rowPixelSpacing);
-    const isSameYSpacing = isEqual(ySpacing, image.columnPixelSpacing);
+    const isSameXSpacing = isEqual(xSpacing, image.columnPixelSpacing);
+    const isSameYSpacing = isEqual(ySpacing, image.rowPixelSpacing);
 
     // using spacing, size, and direction only for now
     return (
diff --git a/packages/tools/test/StackScrollToolMouseWheelTool_test.js b/packages/tools/test/StackScrollToolMouseWheelTool_test.js
index 427d5eac6..d101c979f 100644
--- a/packages/tools/test/StackScrollToolMouseWheelTool_test.js
+++ b/packages/tools/test/StackScrollToolMouseWheelTool_test.js
@@ -4,6 +4,7 @@ import * as testUtils from '../../../utils/test/testUtils';
 
 import * as volumeURI_100_100_10_1_1_1_0_scrolled from './groundTruth/volumeURI_100_100_10_1_1_1_0_scrolled.png';
 import * as imageURI_64_64_0_20_1_1_0_scrolled from './groundTruth/imageURI_64_64_0_20_1_1_0_scrolled.png';
+import * as imageURI_64_64_10_5_3_2_0 from './groundTruth/imageURI_64_64_10_5_3_2_0.png';
 
 const {
   cache,
@@ -18,7 +19,12 @@ const {
 const { Events, ViewportType, InterpolationType } = Enums;
 
 const { registerVolumeLoader } = volumeLoader;
-const { StackScrollMouseWheelTool, ToolGroupManager } = csTools3d;
+const {
+  StackScrollMouseWheelTool,
+  ZoomTool,
+  ToolGroupManager,
+  Enums: { MouseBindings },
+} = csTools3d;
 
 const {
   fakeImageLoader,
@@ -65,6 +71,8 @@ describe('Cornerstone Tools Scroll Wheel: ', () => {
   beforeEach(function () {
     csTools3d.init();
     csTools3d.addTool(StackScrollMouseWheelTool);
+    csTools3d.addTool(ZoomTool);
+
     cache.purgeCache();
     this.DOMElements = [];
 
@@ -72,7 +80,17 @@ describe('Cornerstone Tools Scroll Wheel: ', () => {
     this.stackToolGroup.addTool(StackScrollMouseWheelTool.toolName, {
       debounceIfNotLoaded: false,
     });
+    this.stackToolGroup.addTool(ZoomTool.toolName, {
+      debounceIfNotLoaded: false,
+    });
     this.stackToolGroup.setToolActive(StackScrollMouseWheelTool.toolName);
+    this.stackToolGroup.setToolActive(ZoomTool.toolName, {
+      bindings: [
+        {
+          mouseButton: MouseBindings.Secondary, // Right Click
+        },
+      ],
+    });
 
     this.renderingEngine = new RenderingEngine(renderingEngineId);
     imageLoader.registerImageLoader('fakeImageLoader', fakeImageLoader);
@@ -254,4 +272,119 @@ describe('Cornerstone Tools Scroll Wheel: ', () => {
       done.fail(e);
     }
   });
+
+  it('Should successfully scroll through stack of images of non square spacing', function (done) {
+    const element = createViewport(
+      this.renderingEngine,
+      ViewportType.STACK,
+      256,
+      256
+    );
+    this.DOMElements.push(element);
+
+    const imageId1 = 'fakeImageLoader:imageURI_64_64_10_5_3_2_0';
+    const imageId2 = 'fakeImageLoader:imageURI_64_64_15_5_3_2_0';
+    const vp = this.renderingEngine.getViewport(viewportId);
+
+    let handlerRun = false;
+    function renderEventHandler() {
+      if (handlerRun) return;
+      handlerRun = true;
+
+      // First render is the actual image render
+      const index1 = [0, 0, 4];
+      const index2 = [10, 10, 4];
+
+      const { imageData } = vp.getImageData();
+
+      const {
+        pageX: pageX1,
+        pageY: pageY1,
+        clientX: clientX1,
+        clientY: clientY1,
+      } = createNormalizedMouseEvent(imageData, index1, element, vp);
+
+      const {
+        pageX: pageX2,
+        pageY: pageY2,
+        clientX: clientX2,
+        clientY: clientY2,
+      } = createNormalizedMouseEvent(imageData, index2, element, vp);
+
+      let evt = new MouseEvent('mousedown', {
+        target: element,
+        buttons: 2,
+        clientX: clientX1,
+        clientY: clientY1,
+        pageX: pageX1,
+        pageY: pageY1,
+      });
+      element.dispatchEvent(evt);
+
+      // Mouse move to put the end somewhere else
+      evt = new MouseEvent('mousemove', {
+        target: element,
+        buttons: 2,
+        clientX: clientX2,
+        clientY: clientY2,
+        pageX: pageX2,
+        pageY: pageY2,
+      });
+      document.dispatchEvent(evt);
+
+      setTimeout(() => {
+        evt = new WheelEvent('wheel', {
+          target: element,
+          pageX: pageX1,
+          pageY: pageY1,
+          deltaX: 0,
+          deltaY: 12,
+          deltaMode: 0,
+          wheelDelta: -36,
+          wheelDeltaX: 0,
+          wheelDeltaY: -36,
+        });
+
+        attachEventHandler();
+
+        element.removeEventListener(Events.IMAGE_RENDERED, renderEventHandler);
+        element.dispatchEvent(evt);
+      }, 500);
+    }
+
+    function attachEventHandler() {
+      const canvas = vp.getCanvas();
+
+      element.addEventListener(
+        Events.IMAGE_RENDERED,
+        function secondImageRendered() {
+          // Second render is as a result of scrolling
+          const image = canvas.toDataURL('image/png');
+          element.removeEventListener(
+            Events.IMAGE_RENDERED,
+            secondImageRendered
+          );
+
+          compareImages(
+            image,
+            imageURI_64_64_10_5_3_2_0,
+            'imageURI_64_64_10_5_3_2_0'
+          ).then(done, done.fail);
+        }
+      );
+    }
+
+    element.addEventListener(Events.IMAGE_RENDERED, renderEventHandler);
+
+    this.stackToolGroup.addViewport(vp.id, this.renderingEngine.id);
+
+    try {
+      vp.setStack([imageId1, imageId2], 0).then(() => {
+        vp.setProperties({ interpolationType: InterpolationType.NEAREST });
+        vp.render();
+      });
+    } catch (e) {
+      done.fail(e);
+    }
+  });
 });
diff --git a/packages/tools/test/groundTruth/imageURI_64_64_10_5_3_2_0.png b/packages/tools/test/groundTruth/imageURI_64_64_10_5_3_2_0.png
new file mode 100644
index 000000000..40af80b2f
Binary files /dev/null and b/packages/tools/test/groundTruth/imageURI_64_64_10_5_3_2_0.png differ
diff --git a/utils/test/testUtilsImageLoader.js b/utils/test/testUtilsImageLoader.js
index ce4d93f54..61a056180 100644
--- a/utils/test/testUtilsImageLoader.js
+++ b/utils/test/testUtilsImageLoader.js
@@ -49,8 +49,8 @@ const fakeImageLoader = (imageId) => {
     windowWidth: 400,
     maxPixelValue: 255,
     minPixelValue: 0,
-    rowPixelSpacing: 1,
-    columnPixelSpacing: 1,
+    rowPixelSpacing: y_spacing,
+    columnPixelSpacing: x_spacing,
     getPixelData: () => pixelData,
     sizeInBytes: rows * columns * 1, // 1 byte for now
     FrameOfReferenceUID: 'Stack_Frame_Of_Reference',
@@ -119,8 +119,8 @@ function fakeMetaDataProvider(type, imageId) {
       columnCosines: [0, 1, 0],
       imagePositionPatient: [0, 0, 0],
       pixelSpacing: [x_spacing, y_spacing],
-      rowPixelSpacing: x_spacing,
-      columnPixelSpacing: y_spacing,
+      rowPixelSpacing: y_spacing,
+      columnPixelSpacing: x_spacing,
     };
 
     return imagePlaneModule;