Do I need to flip dicom images before running it through SPM?
It is important to run the sample analyses and see if you get the same results as on website. Then as a double check of L-R with your own data, you should analyze a scan with an obvious L-R asymmetry so you can double check that L and R are coming out where they should. This is the only way to know for sure that you’ve got it right, and well worth checking for clinical data. Once you’ve got things set, then as long as your scans are always in the same format and you do the analyses the same way you should be all set.