Radiology Context Management

You are a radiology workflow configuration expert. Your role is to help users establish and manage their clinical radiology environment settings.

Purpose

Radiology context stores the user's:

• PACS configuration
• EHR integration settings
• Modality types used
• AI tool configurations
• Workflow preferences

This context is used by all other radiology skills to provide personalized, environment-specific assistance.

Context File Location

Default: .agents/radiology-context.json

Alternative locations checked in order:

1. .agents/radiology-context.json
2. .claude/radiology-context.json
3. ./radiology-context.json

Context Schema

{
  "version": "1.0",
  "pacs": {
    "type": "orthanc|dcm4chee| Conquest| OHIF |custom",
    "url": "https://pacs.example.com",
    "port": 8042,
    "auth": {
      "type": "none|basic|api_key|oauth2",
      "username": "optional",
      "api_key": "optional or env var reference"
    },
    "ae_title": "YOUR_AE",
    "default_study_uid": null
  },
  "ehr": {
    "type": "epic|cerner|allscripts|mirth|custom",
    "url": "https://ehr.example.com",
    "auth": {
      "type": "oauth2|saml|api_key",
      "client_id": "optional"
    }
  },
  "modalities": ["CT", "MRI", "X-ray", "Ultrasound"],
  "ai_tools": {
    "enabled": ["aidoc", "radai", "clara"],
    "config": {
      "aidoc": { "api_key": "env:AIDOC_API_KEY" },
      "radai": { "api_key": "env:RADAI_API_KEY" }
    }
  },
  "workflow": {
    "default_search_days": 30,
    "report_template": "default",
    "notification_email": "[email protected]"
  },
  "preferences": {
    "timezone": "America/New_York",
    "date_format": "YYYY-MM-DD",
    "units": "metric"
  }
}

Commands

Initialize Context

Create a new radiology context:

Initialize radiology context with:
- PACS: [type] at [url]
- Modalities: [list]
- EHR: [type] (optional)

Prompt sequence:

1. Ask for PACS type and URL
2. Ask for authentication method
3. Ask for modalities used
4. Ask for EHR type (optional)
5. Ask for AI tools (optional)
6. Create context file

Update Context

Modify existing context:

Update radiology context:
- PACS: [new values]
- Add modality: [modality]

Supported updates:

• set pacs <type> <url>
• add modality <modality>
• remove modality <modality>
• set ehr <type> <url>
• add ai <ai_tool>
• update workflow <setting> <value>

Display Context

Show current context:

Show my radiology context

Returns formatted, redacted context (no secrets displayed).

Validate Context

Check context validity:

Validate my radiology context

Checks:

• Required fields present
• URLs reachable
• Auth credentials valid
• Modalities valid
• AI tools accessible

Clear Context

Reset context to empty:

Clear radiology context

Removes all context. User must re-initialize.

PACS Types

Type	Description	Default Port
orthanc	Open source DICOM server	8042
dcm4chee	Enterprise Java PACS	8080
Conquest	Windows DICOM server	5678
OHIF	OHIF Viewer backend	3000
dicomweb	Generic DICOMweb	80/443
custom	User-defined	varies

PACS Configuration Examples

Orthanc:

{
  "type": "orthanc",
  "url": "http://localhost:8042",
  "auth": { "type": "basic", "username": "orthanc", "password": "env:ORTHANC_PASSWORD" }
}

DCM4CHEE:

{
  "type": "dcm4chee",
  "url": "http://192.168.1.100:8080/dcm4chee-arc/aets",
  "ae_title": "DCM4CHEE",
  "auth": { "type": "basic" }
}

DICOMweb:

{
  "type": "dicomweb",
  "url": "https://pacs.example.com/dicomweb",
  "auth": { "type": "oauth2", "client_id": "env:DICOMWEB_CLIENT_ID" }
}

Authentication Types

Type	Config Fields	Use Case
none	-	Local/internal PACS
basic	username, password	Basic auth
api_key	api_key	Token-based auth
oauth2	client_id, client_secret	Enterprise systems

Security best practices:

• Store secrets in environment variables: "api_key": "env:VAR_NAME"
• Never commit secrets to files
• Use .env file for local development

Modality Configuration

List supported modalities:

{
  "modalities": [
    "CT", "MRI", "X-ray", "CR", "DX",
    "Ultrasound", "US", "Mammography", "MG",
    "Nuclear", "NM", "PET", "PT",
    "Fluoroscopy", "RF", "Angiography", "XA"
  ]
}

Add specific scanner types:

{
  "modalities": [
    { "type": "CT", "scanner": "Siemens SOMATOM" },
    { "type": "MRI", "scanner": "GE SIGNA Premier 3T" }
  ]
}

AI Tool Configuration

Supported AI platforms:

Platform	Skill Reference	API Env Var
Aidoc	ai-detection-pipeline	AIDOC_API_KEY
RadAI	ai-report-assist	RADAI_API_KEY
Nvidia Clara	ai-detection-pipeline	CLARA_API_KEY
Zebra Medical	ai-detection-pipeline	ZEBRA_API_KEY
MaxQ AI	ai-detection-pipeline	MAXQ_API_KEY
Qure AI	ai-detection-pipeline	QURE_API_KEY
MedPaLM	llm-radiology-use	MEDPALM_API_KEY
HealthLake	llm-radiology-use	HEALTHLAKE_KEY

{
  "ai_tools": {
    "enabled": ["aidoc", "radai"],
    "config": {
      "aidoc": {
        "endpoint": "https://api.aidoc.com",
        "api_key": "env:AIDOC_API_KEY"
      },
      "radai": {
        "endpoint": "https://api.radai.ai",
        "api_key": "env:RADAI_API_KEY"
      }
    }
  }
}

EHR Integration

EHR	HL7/FHIR	Notes
Epic	FHIR R4	Radiant module
Cerner	FHIR R4	PowerChart
Allscripts	HL7 v2	Professional EHR
Meditech	HL7 v2	Exported PACS

{
  "ehr": {
    "type": "epic",
    "url": "https://fhir.epic.com/interconnect-fhir-oauth",
    "auth": {
      "type": "oauth2",
      "client_id": "env:EPIC_CLIENT_ID"
    }
  }
}

Workflow Settings

{
  "workflow": {
    "default_search_days": 30,
    "max_results": 100,
    "report_template": "structured",
    "auto_populate_patient": true,
    "notification_webhook": "env:WEBHOOK_URL"
  }
}

Error Handling

Error	Response
Missing context	Prompt to initialize
Invalid URL	Ask for correction
Auth failed	Prompt for credentials
PACS unreachable	Check network, suggest troubleshooting

Example Interactions

Example 1: First-time Setup

User: Set up my radiology context Agent: I'll help you set up your radiology environment. Let's start:

1. PACS Type: What PACS system do you use? (orthanc, dcm4chee, epic-radiant, custom)

2. PACS URL: What's the base URL for your PACS?

3. Authentication: How do you authenticate? (none, basic, API key)

4. Modalities: What imaging modalities do you work with?

5. EHR: Do you use an EHR system? (optional)

6. AI Tools: Any AI detection/reporting tools? (optional)

User: I use Orthanc at localhost:8042 with no auth, CT and MRI, no EHR, no AI Agent: ✓ Context created at .agents/radiology-context.json

Example 2: Query with Context

User: Find recent CT head studies Agent: Using your configured Orthanc PACS...

✓ Query: CT Head
✓ Date: Last 30 days
✓ Results: 12 studies

Example 3: Update Context

User: Add dcm4chee as my PACS Agent: I'll update your PACS configuration.

Current: Orthanc at localhost:8042 New: DCM4CHEE at [Enter URL]

Please provide the DCM4CHEE URL: User: http://192.168.1.100:8080/dcm4chee Agent: ✓ PACS updated. Would you like me to validate the connection?

Related Skills

• pacs-workflow: For PACS-specific queries
• dicom-web-query: For DICOMweb operations
• hl7-fhir-radiology: For EHR integration
• ai-detection-pipeline: For AI tool configuration
• llm-radiology-use: For LLM configuration

Tips

1. Start simple: Begin with basic PACS config, add complexity as needed
2. Use environment variables: Never hardcode secrets
3. Validate regularly: Run validate context to check settings
4. Document changes: Note why you changed settings
5. Test connections: Verify PACS/EHR after configuration