aitrium-radiotherapy

name	aitrium-radiotherapy
description	Inspects radiotherapy DICOM studies, computes DVH metrics, and runs policy-driven metadata anonymization using rt_inspect, rt_dvh, rt_dvh_metrics, and rt_anonymize_metadata.
compatibility	Requires an MCP server named aitrium-radiotherapy exposing tools rt_inspect, rt_dvh, rt_dvh_metrics, rt_anonymize_metadata, rt_anonymize_template_get, rt_anonymize_template_update, and rt_anonymize_template_reset. Intended for tool-based agents (Codex/Claude MCP), not shell-only workflows.

RT Analysis Skill

Use this skill with the aitrium-radiotherapy MCP server.

Preconditions

1. Confirm MCP connectivity before calling tools.
2. If unavailable, ask the user to register/restart MCP first.

Host checks:

• Codex: codex mcp get aitrium-radiotherapy --json
• Claude Code: claude mcp get aitrium-radiotherapy

Available Tools

• aitrium-radiotherapy:rt_inspect
• aitrium-radiotherapy:rt_dvh
• aitrium-radiotherapy:rt_dvh_metrics
• aitrium-radiotherapy:rt_anonymize_metadata
• aitrium-radiotherapy:rt_anonymize_template_get
• aitrium-radiotherapy:rt_anonymize_template_update
• aitrium-radiotherapy:rt_anonymize_template_reset

Invocation Rules

• rt_inspect, rt_dvh, rt_dvh_metrics, rt_anonymize_metadata, and rt_anonymize_template_* are MCP tool names, not shell binaries.
• Do not run shell commands like which rt_inspect or rt_inspect ....
• Do not replace tool calls with local fallback scripts unless the user explicitly asks.

Call via MCP (fully qualified tool names):

• aitrium-radiotherapy:rt_inspect with {"path":"<dicom_directory>"}
• aitrium-radiotherapy:rt_dvh with {"rtstruct_path":"<RS.dcm>","rtdose_path":"<RD.dcm>","structures":["PTV"],"interpolation":false,"z_segments":0,"include_curves":false}
• aitrium-radiotherapy:rt_dvh_metrics with {"rtstruct_path":"<RS.dcm>","rtdose_path":"<RD.dcm>","structures":["PTV"],"metrics":[{"id":"d95","type":"dose_at_volume","volume_percent":95},{"id":"v60","type":"volume_at_dose","dose_gy":60,"volume_unit":"percent"},{"id":"mean","type":"stat","stat":"mean_gy"}]}
• aitrium-radiotherapy:rt_anonymize_metadata with {"source_path":"<dicom_directory>","output_path":"<anonymized_output_dir>","template":"aitrium_default","dry_run":true}
• aitrium-radiotherapy:rt_anonymize_template_get with {}
• aitrium-radiotherapy:rt_anonymize_template_update with {"policy_overrides":{"vr_rules":{"DA":{"action":"replace","replace":{"mode":"date_transform","date_strategy":"fixed_shift_dataset","days_shift":90}}}}}
• aitrium-radiotherapy:rt_anonymize_template_reset with {}

Do not use MCP CLI commands as a substitute for tool invocation:

• Avoid which rt_inspect
• Avoid codex mcp ... as a tool-call path
• Call the MCP tools directly through the agent's tool interface

Workflow

0. Before running inspection or DVH tools on user-provided dataset paths, ask whether to create and use an anonymized copy first. Recommend anonymize-first by default.
1. Call aitrium-radiotherapy:rt_inspect first to discover available studies, structures, plans, and dose grids.
2. Select explicit rtstruct_path and rtdose_path from inspection output.
3. Prefer aitrium-radiotherapy:rt_dvh_metrics for atomic dose-coverage requests to minimize token usage.
4. Use aitrium-radiotherapy:rt_dvh with include_curves=true only when full DVH curves are explicitly needed.
5. Use DVH stats/metrics for dose coverage checks.
6. Use aitrium-radiotherapy:rt_anonymize_metadata for metadata-only de-identification.

Interpretation Guidance

• D95_gy: dose received by at least 95% of a structure volume.
• D2_gy: near-maximum dose metric.
• volumes_pct: cumulative percent volume receiving at least each dose bin (returned when include_curves=true).
• homogeneity_index: (D2 - D98) / D50.

Units

• Dose: Gy
• Volume: cc and %

Safety

• Treat output as computational support, not a clinical decision on its own.
• Metadata anonymization is header-only; do not claim pixel-data anonymization.
• For user-provided patient datasets, default to anonymize-first workflow (rt_anonymize_metadata dry-run, then write to new output path) unless the user explicitly asks to process originals.
• In write mode, anonymized DICOM files are emitted as MODALITY.SOPInstanceUID.dcm.
• Sequence containers are recursively processed; if policy sets replace on a sequence, runtime applies keep+recurse and emits a warning.
• Surface parsing/matching warnings to users in final responses.
• If a tool call fails with Unexpected response type, treat it as MCP protocol mismatch and ask for server reinstall/restart before retrying.