The problem is that where i had the issue actually had nothing to do with excel or aspose. The code i reference below is used simply to flatten and save the image in the picturebox to a .bmp file.

Im betting that the term Drawing is used within the Aspose methods and thats what was screwing me up there.

Code:
Private Function SaveImage(ByVal name As String)

        Dim bmp As New Drawing.Bitmap(xray.Image.Width, xray.Image.Height)
        xray.DrawToBitmap(bmp, New Rectangle(0, 0, bmp.Width, bmp.Height))
        bmp.Save("c:\Chiro Report\" & name)

        Return 0

    End Function