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You use a combination of combining same colors so the center is a hole and then select or create cutpaths to finish the piece. You must use the same vinyl throughout with foil fills. All fills would be set to overprint.
Now place the vectors on top of your image, size and position it and it should preview and print/cut correctly.
You would add the color change and probably set a choke and spread if you're using more than one spot color. Depending on the colors used, you may also choose to just set CMYK colors instead of spot colors .... especially if you have a CMYK image already being run. This nearly always eliminates the need for chokes and spreads. If you want to reduce or eliminate any graininess in these fills, select a halftone type of Classical Dot and bump the LPI setting up into the 70 to 90 range.
To run it with the entire image behind it showing, you set the text to overprint and turn all cuts off. then set a rectangle or whatever shape you want to use to cut out the image.
Learning the different ways to achieve any given effect is different with Omega and in general when you are working with spot colors. Your tools are:
Cuts On or Off
Spot or CMYK
Overprint or Not (Not knocksout all print beneath it)
Printing on films other than white .... with or without primers.