Machine learning trains to tune settings. For training, the user interactions with the image parameters (i.e., settings) as part of ongoing examination of patients are used to establish the ground truth positive and negative examples of settings instead of relying on an expert review of collected samples. Patient information, location information, and/or user information may also be included in the training data so that the network is trained to provide settings for different situations based on the included information. During application, the patient is imaged. The initial or subsequent image is input with other information (e.g., patient, user, and/or location information) to the machine-trained network to output settings to be used for improved imaging in the situation.