A multimedia telephony services over internet protocol (IP) multimedia subsystems (IMS) (MTSI) receiver operable to support region of interest (ROI) signaling with a MTSI sender is disclosed. The MTSI receiver can define a requested region of interest (ROI). The MTSI receiver can map the requested ROI to one or more pan, tilt, zoom and focus (PTZF) commands. The MTSI receiver can encode the one or more PTZF commands for transmission to the MTSI sender via real-time transport protocol (RTP) packets, wherein the one or more PTZF commands represent the requested ROI.