Try using vtkTransform
class, and apply a 180 degrees rotation around the axe (1, 1, 0) => x = y = 1 ; z = 0
void vtkTransform::RotateWXYZ (double angle, double x, double y, double z );
Create a rotation matrix and concatenate it with the current transformation according to PreMultiply or PostMultiply semantics. The angle is in degrees, and (x,y,z) specifies the axis that the rotation will be performed around.
vtkSmartPointer<vtkTransform> rotation = vtkSmartPointer<vtkTransform>::New();
rotation->RotateWXYZ (180, 1.0, 1.0, 0);
// rotation->setInputConnection( DicomReaderImage->GetOutputPort () ); // link your image into your pipeline
rotation->Update ();