Preprocess imaging
Agent Skills for medical research — literature search, reporting-guideline & citation checks, statistics, publication figures, submission. Works with Claude Code, Codex, Cursor & GitHub Copilot. Built by a physician-researcher, tested on real publications. MIT.
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Design or audit the data-preparation stage of a medical-imaging model — DICOM/NIfTI intake, resampling and intensity normalisation, and the augmentation plan — so the pipeline is leakage-safe before model-scaffold builds the training repo. Emits a declarative preprocessing manifest and a deterministic data-stage leakage gate that catches the leaks a split table cannot see: a dataset-level normaliser fit on non-train data, any data-fitted transform run before the split, and the same patient's slices crossing splits. Integrates MONAI / TorchIO transforms; it does not reimplement them, and it never runs preprocessing on real patient data.
SKILL.md
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Preprocess-Imaging Skill
Purpose
This skill designs and audits the data-preparation stage of a medical-imaging model — the stage before a training repo is built — and proves it is leakage-safe by construction. Data leakage enters one step earlier than the split table can see: a normaliser fit on the whole dataset, a data-fitted transform run before the split exists, or a patient whose slices land in more than one partition. Each silently inflates every downstream metric (Kapoor & Narayanan, Patterns 2023; Varoquaux & Cheplygina, npj Digit Med 2022; CLAIM 2024 data items).
It is the missing first link in the lane: preprocess-imaging (prepare + audit) →
/model-scaffold (build) → /model-validation (validate the split) → /model-evaluation +
/analyze-stats (metrics) → /write-paper + /check-reporting (publish). It integrates
MONAI / TorchIO transforms (referenced in the emitted plan); it does not reimplement them, and it
never executes preprocessing on real patient data.
When to use
- You have a data manifest (one row per image/slice with a patient/subject ID) and want a leakage-safe preprocessing plan + a machine-checkable manifest before scaffolding a model.
- You want to audit an existing preprocessing pipeline for data-stage leakage.
When NOT to use
- Auditing the train/val/test split table itself →
/model-validation(split-leakage gate). - Building the training repo / model code →
/model-scaffold(it consumes this manifest). - Choosing the architecture →
/architecture-zoo. - Held-out metrics / calibration →
/model-evaluationthen/analyze-stats. - Reimplementing MONAI / TorchIO transforms → out of scope (this skill wires and audits them).
Workflow
Phase 1 — Inventory the data and the intended steps
Collect: modality (CT / MR / X-ray / US / path), the data manifest (one row per image/slice with a
patient_id), the intended resample spacing, the intensity transform (fixed HU window vs a fitted
z-score / min-max / histogram match), and the augmentation plan. See
references/preprocessing_guide.md for modality-aware guidance
(what normalisation is standard per modality, which augmentations preserve vs break physiology).
Phase 2 — Decide fit scope and order (the leakage-safe rules)
- Fit dataset-level normalisation on the training split only — never on all/full/test.
- Run any data-fitted transform AFTER the split — before the split there is no train/test distinction, so the fit spans partitions.
- Prefer per-image (per-sample) normalisation where clinically appropriate: it uses only that image's own statistics and is leakage-free even before the split.
- Keep augmentation train-only — augmenting val/test folds undisclosed test-time augmentation into the reported metric.
- Split at the patient level, then map slices to their patient's split (never split slices).
Phase 3 — Emit the preprocessing manifest
Write a declarative JSON manifest that model-scaffold consumes and the gate checks:
{
"split_seed": 42,
"transforms": [
{"name": "hu_window", "type": "clip", "fit_scope": "none", "stage": "before_split"},
{"name": "train_zscore", "type": "standardize", "fit_scope": "train", "stage": "after_split"},
{"name": "flip_rotate", "type": "augmentation", "stage": "after_split", "applies_to": ["train"]}
],
"split_assignment": [
{"patient_id": "P001", "unit_id": "P001_s1", "split": "train"}
]
}
fit_scope: train (OK) · all/full/dataset/test (leak) · sample/per_image/none/fixed
(not data-fitted, leakage-free). stage: before_split / after_split.
Declare the fit scope of resampling too. A target spacing you chose in advance is fixed and
never leaks (fit_scope: fixed). A target derived from the cohort does: nnU-Net sets its target
spacing from a percentile of the dataset fingerprint, so a resample fitted over every case carries
held-out geometry into the training grid exactly as an intensity statistic would. Which one you
have is decided by the fingerprint's scope, not by the word "resample".
Phase 4 — Gate the manifest (deterministic)
python3 scripts/check_preprocessing_leakage.py --manifest preprocessing_manifest.json --strict
Verdicts: PREPROCESS_BEFORE_SPLIT, NORMALIZATION_LEAKAGE, PATIENT_CROSS_SPLIT (Major);
AUGMENTATION_ON_EVAL, UNSPECIFIED_FIT_SCOPE, MISSING_SEED (Minor). The verdict is reproduced
by set arithmetic + rule on the manifest, never asserted from prose. A green gate is a precondition
for handing the manifest to /model-scaffold.
Integration
- Feeds
/model-scaffold— the audited manifest is the scaffold's preprocessing input; itssplit_assignmentis the same patient-level split/model-validationlater re-verifies. /self-reviewmodel_developmentprobe audits data-stage leakage in a finished manuscript; this skill produces the leakage-safe pipeline it looks for./check-reporting— the manifest documents the CLAIM 2024 / TRIPOD+AI data-preprocessing items.
Anti-Hallucination
- Never fabricate image statistics, patient IDs, or split assignments. Every value in the manifest comes from the real data manifest and the researcher's declared pipeline — never invented. This skill designs and audits the plan; it does not run preprocessing on real patient data or synthesise the images it describes.
- Never report a preprocessing-audit "pass" without running
check_preprocessing_leakage.py. The leakage verdict is reproduced deterministically (rule + set arithmetic on the manifest), never asserted from prose. - Never label a dataset-fitted transform as per-sample to clear the gate. The manifest's
type/fit_scope/stagemust describe what the code actually does; a mislabelled transform hides a real leak the gate would otherwise catch. - Integrate, don't reimplement. Reference MONAI / TorchIO transforms; do not write a new normalisation/resampling implementation or claim results for one.
Reproducible challenge
scripts/check_preprocessing_leakage_challenge/ ships a synthetic leak/clean manifest pair with a
network-free verify.sh wired into the skill's validation commands.