Solved it
In the properties for the Desktop Shortcut, I need to set the target:
"C:\Program Files (x86)\Qimage\Qimage.exe" "E:\Qimage\save\R2400-A4.prt"
Works as expected. For those of you who save printer set-ups for different printers and papers and haven't tried this, copy and paste the Qimage shortcut to your desktop. rename as needed. Right click and select Properties. Change the target as above for Vista and Windows 7.
For Windows XP change as below:
"C:\Program Files\Qimage\Qimage.exe" "E:\Qimage\save\R2400-A4.prt"
In my case the Qimage saved setting are on my E: drive and the you need to change the printer name to whatever you call yours. For me, in this example, it's an Epson R2400, A4 paper size.
Good luck.