feat(imaging-ai): add DICOM preview and AI diagnosis support

app/Config/Routes.php

@@ -645,6 +645,9 @@ $routes->post('diagnosis/final-update/(:num)', 'Diagnosis::finalUpdate/$1');
 $routes->post('diagnosis/final-update-xray/(:num)', 'Diagnosis::finalUpdateXray/$1');
 $routes->post('diagnosis/confirm-report/(:num)', 'Diagnosis::confirmReport/$1');
 $routes->post('diagnosis/confirm-report-xray/(:num)', 'Diagnosis::confirmReportXray/$1');
+// Editor JS compatibility aliases
+$routes->post('diagnosis/update-report/(:num)', 'Diagnosis::finalUpdateXray/$1');
+$routes->post('diagnosis/report-verify/(:num)', 'Diagnosis::confirmReportXray/$1');
 $routes->match(['get', 'post'], 'diagnosis/get-template-xray/(:num)', 'Diagnosis::getTemplateXray/$1');
 $routes->post('diagnosis/remove-test/(:num)', 'Diagnosis::removeTest/$1');
 $routes->post('diagnosis/update-combine-report', 'Diagnosis::updateCombineReport');
@@ -653,6 +656,7 @@ $routes->post('diagnosis/upload-report-file', 'Diagnosis::uploadReportFile');
 $routes->get('diagnosis/report-file-list/(:num)/(:num)', 'Diagnosis::reportFileList/$1/$2');
 $routes->get('diagnosis/report-file-list/(:num)/(:num)/(:num)', 'Diagnosis::reportFileList/$1/$2/$3');
 $routes->get('diagnosis/imaging-upload-gallery/(:num)/(:num)/(:num)', 'Diagnosis::imagingUploadGallery/$1/$2/$3');
+$routes->get('diagnosis/imaging-dicom-preview/(:num)', 'Diagnosis::imagingDicomPreview/$1');
 $routes->post('diagnosis/imaging-ai-diagnosis/(:num)', 'Diagnosis::imagingAiDiagnosis/$1');
 $routes->get('diagnosis/select-lab-radiology/(:num)/(:num)', 'Diagnosis::selectLabRadiology/$1/$2');
 $routes->get('diagnosis/print-pdf-create/(:num)/(:num)/(:num)', 'Diagnosis::printPdfCreate/$1/$2/$3');
@@ -746,6 +750,7 @@ $routes->group('setting', static function($routes) {
     $routes->get('admin/ai-settings', 'Setting\\AiSettings::index');
     $routes->post('admin/ai-settings/save', 'Setting\\AiSettings::save');
     $routes->post('admin/ai-settings/test', 'Setting\\AiSettings::test');
+    $routes->post('admin/ai-settings/usage', 'Setting\\AiSettings::usage');
     $routes->get('admin/doctor', 'Setting\\Doctor::index');
     $routes->get('admin/doctor/new', 'Setting\\Doctor::create');
     $routes->post('admin/doctor/new', 'Setting\\Doctor::store');

app/Controllers/Diagnosis.php

@@ -1548,6 +1548,7 @@ class Diagnosis extends BaseController
             $ext = strtolower(pathinfo((string) ($row['file_name'] ?? ''), PATHINFO_EXTENSION));
             $isImage = (int) ($row['is_image'] ?? 0) === 1 || str_starts_with($mime, 'image/');
             $isPdf = $ext === 'pdf' || $mime === 'application/pdf';
+            $isDicom = $this->isDicomMimeOrExtension($mime, $ext);
 
             $files[] = [
                 'id' => (int) ($row['id'] ?? 0),
@@ -1556,6 +1557,8 @@ class Diagnosis extends BaseController
                 'url' => $url,
                 'is_image' => $isImage,
                 'is_pdf' => $isPdf,
+                'is_dicom' => $isDicom,
+                'dicom_preview_url' => $isDicom ? base_url('diagnosis/imaging-dicom-preview/' . (int) ($row['id'] ?? 0)) : '',
                 'insert_time' => (string) ($row['insert_time'] ?? $row['insert_date'] ?? ''),
                 'ai_status' => (string) ($row['ai_status'] ?? ''),
                 'ai_alert_text' => (string) ($row['ai_alert_text'] ?? ''),
@@ -1569,6 +1572,50 @@ class Diagnosis extends BaseController
         ]);
     }
 
+    public function imagingDicomPreview($fileId)
+    {
+        $fileId = (int) $fileId;
+        if ($fileId <= 0 || ! $this->db->tableExists('file_upload_data')) {
+            return $this->response->setStatusCode(404)->setBody('DICOM file not found');
+        }
+
+        $fileRow = $this->db->table('file_upload_data')
+            ->where('id', $fileId)
+            ->where('isdelete', 0)
+            ->get(1)
+            ->getRowArray();
+
+        if (empty($fileRow)) {
+            return $this->response->setStatusCode(404)->setBody('DICOM file not found');
+        }
+
+        $absolutePath = $this->resolveUploadAbsolutePath((string) ($fileRow['full_path'] ?? ''));
+        if ($absolutePath === '' || ! is_file($absolutePath)) {
+            return $this->response->setStatusCode(404)->setBody('DICOM file missing on server');
+        }
+
+        $mime = $this->detectMimeType($absolutePath);
+        $ext = strtolower(pathinfo($absolutePath, PATHINFO_EXTENSION));
+        if (! $this->isDicomMimeOrExtension($mime, $ext)) {
+            return $this->response->setStatusCode(415)->setBody('File is not a DICOM');
+        }
+
+        $preview = $this->callAiServerDicomPreview($absolutePath, $mime);
+        if (($preview['error'] ?? '') !== '') {
+            return $this->response->setStatusCode(422)->setBody((string) $preview['error']);
+        }
+
+        $bytes = (string) ($preview['bytes'] ?? '');
+        if ($bytes === '') {
+            return $this->response->setStatusCode(422)->setBody('Unable to render DICOM preview');
+        }
+
+        return $this->response
+            ->setHeader('Content-Type', (string) ($preview['mime'] ?? 'image/jpeg'))
+            ->setHeader('Cache-Control', 'no-store, no-cache, must-revalidate')
+            ->setBody($bytes);
+    }
+
     public function uploadReportFile()
     {
         if (! $this->request->isAJAX()) {
@@ -1595,9 +1642,9 @@ class Diagnosis extends BaseController
         }
 
         $ext = strtolower((string) $upload->getExtension());
-        $allowed = ['jpg', 'jpeg', 'png', 'webp', 'bmp', 'gif', 'pdf'];
+        $allowed = ['jpg', 'jpeg', 'png', 'webp', 'bmp', 'gif', 'pdf', 'dcm', 'dicom'];
         if (! in_array($ext, $allowed, true)) {
-            return $this->response->setJSON(['update' => 0, 'error_text' => 'Unsupported file type']);
+            return $this->response->setJSON(['update' => 0, 'error_text' => 'Unsupported file type. Allowed: image, PDF, DICOM (.dcm)']);
         }
 
         $targetDir = ROOTPATH . 'public' . DIRECTORY_SEPARATOR . 'uploads' . DIRECTORY_SEPARATOR . 'diagnosis' . DIRECTORY_SEPARATOR . date('Y') . DIRECTORY_SEPARATOR . date('m');
@@ -1719,7 +1766,7 @@ class Diagnosis extends BaseController
 
         $ocrText = $this->extractTextFromLabFile($absolutePath);
         if ($ocrText === '') {
-            return $this->response->setJSON(['update' => 0, 'error_text' => 'OCR failed. Configure AZURE_DOCINTEL_ENDPOINT/KEY or use readable image.']);
+            return $this->response->setJSON(['update' => 0, 'error_text' => 'OCR failed. Configure DIAGNOSIS_AI_OCR_ENDPOINT on your AI server.']);
         }
 
         $parsed = $this->parseLabValuesWithAi($ocrText, $panelName);
@@ -1741,7 +1788,8 @@ class Diagnosis extends BaseController
             $panelName,
             $modelName,
             $ocrText,
-            $rawResponse
+            $rawResponse,
+            (string) ($parsed['provider'] ?? 'ai-server')
         );
 
         if ($batchId <= 0) {
@@ -1786,7 +1834,7 @@ class Diagnosis extends BaseController
         return $this->response->setJSON([
             'update' => 1,
             'error_text' => 'AI extracted ' . $storedCount . ' values. Doctor verification pending.',
-            'ai_provider' => (string) ($parsed['provider'] ?? 'azure-openai'),
+            'ai_provider' => (string) ($parsed['provider'] ?? 'ai-server'),
             'ai_model' => $modelName,
             'batch_id' => $batchId,
             'stored_values' => $storedCount,
@@ -1933,23 +1981,56 @@ class Diagnosis extends BaseController
                 $ocrChunks[] = 'FILE: ' . $fileName . "\n" . $ocrText;
             }
 
-            if (str_starts_with($mime, 'image/') && count($visionImages) < 4) {
+            $ext = strtolower(pathinfo($absolutePath, PATHINFO_EXTENSION));
-                $imagePayload = $this->buildVisionImagePayload($absolutePath, $mime);
+            if ((str_starts_with($mime, 'image/') || $this->isDicomMimeOrExtension($mime, $ext)) && count($visionImages) < 4) {
-                if ($imagePayload !== '') {
+                $visionImages[] = [
-                    $visionImages[] = [
+                    'abs_path' => $absolutePath,
-                        'type' => 'image_url',
+                    'mime' => $mime,
-                        'image_url' => ['url' => $imagePayload],
+                ];
-                    ];
+            }
+        }
+
+        $patientName = trim((string) ($labRequest['patient_name'] ?? 'Unknown'));
+        $patientAge = 0;
+        $patientGender = 'Unknown';
+        $patientId = (int) ($labRequest['patient_id'] ?? 0);
+        if ($patientId > 0 && $this->db->tableExists('patient_master')) {
+            $patient = $this->db->table('patient_master')
+                ->select('gender, age, age_in_month, dob')
+                ->where('id', $patientId)
+                ->get(1)
+                ->getRowArray();
+
+            $genderRaw = (int) ($patient['gender'] ?? 0);
+            $patientGender = $genderRaw === 1 ? 'Male' : ($genderRaw === 2 ? 'Female' : 'Unknown');
+
+            $patientAge = (int) ($patient['age'] ?? 0);
+            if ($patientAge <= 0) {
+                $months = (int) ($patient['age_in_month'] ?? 0);
+                if ($months > 0) {
+                    $patientAge = max(1, (int) floor($months / 12));
+                }
+            }
+            if ($patientAge <= 0) {
+                $dob = trim((string) ($patient['dob'] ?? ''));
+                if ($dob !== '' && $dob !== '0000-00-00') {
+                    try {
+                        $patientAge = (int) ((new \DateTime($dob))->diff(new \DateTime('today'))->y ?? 0);
+                    } catch (\Throwable $e) {
+                        $patientAge = 0;
+                    }
                 }
             }
         }
 
-        $analysis = $this->generateImagingDiagnosisDraft($studyName, $ocrChunks, $visionImages);
+        $analysis = $this->generateImagingDiagnosisDraft($studyName, $ocrChunks, $visionImages, $patientName, $patientAge, $patientGender);
         if (($analysis['error'] ?? '') !== '') {
             $this->updateImagingFileAiState($fileIds, 'failed', (string) $analysis['error'], 1);
             return $this->response->setJSON(['update' => 0, 'error_text' => (string) $analysis['error']]);
         }
 
+        $promptUsed = $this->buildImagingDiagnosisPrompt($studyName);
+
         $rawPayload = [
             'type' => 'imaging-ai-diagnosis',
             'request_id' => $labReqId,
@@ -1960,8 +2041,9 @@ class Diagnosis extends BaseController
             'findings_html' => (string) ($analysis['findings_html'] ?? ''),
             'impression_html' => (string) ($analysis['impression_html'] ?? ''),
             'summary_text' => (string) ($analysis['summary_text'] ?? ''),
-            'provider' => (string) ($analysis['provider'] ?? 'azure-openai'),
+            'provider' => (string) ($analysis['provider'] ?? 'ai-server'),
             'model' => (string) ($analysis['model'] ?? ''),
+            'prompt_used' => $promptUsed,
             'source_files' => $sourceFiles,
             'raw' => $analysis['raw'] ?? [],
         ];
@@ -1974,7 +2056,8 @@ class Diagnosis extends BaseController
             $studyName,
             (string) ($analysis['model'] ?? ''),
             $ocrText,
-            (string) json_encode($rawPayload, JSON_UNESCAPED_UNICODE | JSON_UNESCAPED_SLASHES)
+            (string) json_encode($rawPayload, JSON_UNESCAPED_UNICODE | JSON_UNESCAPED_SLASHES),
+            (string) ($analysis['provider'] ?? 'ai-server')
         );
 
         if ($batchId <= 0) {
@@ -1999,7 +2082,7 @@ class Diagnosis extends BaseController
             'findings_html' => (string) ($analysis['findings_html'] ?? ''),
             'impression_html' => (string) ($analysis['impression_html'] ?? ''),
             'summary_text' => (string) ($analysis['summary_text'] ?? ''),
-            'provider' => (string) ($analysis['provider'] ?? 'azure-openai'),
+            'provider' => (string) ($analysis['provider'] ?? 'ai-server'),
             'model' => (string) ($analysis['model'] ?? ''),
         ]);
 
@@ -2023,14 +2106,15 @@ class Diagnosis extends BaseController
         string $panelName,
         string $modelName,
         string $ocrText,
-        string $rawResponse
+        string $rawResponse,
+        string $provider = 'ai-server'
     ): int {
         $ok = $this->db->table('lab_ai_extraction_batches')->insert([
             'invoice_id' => $invoiceId,
             'lab_type' => $labType,
             'file_upload_id' => $fileId,
             'panel_name' => $panelName,
-            'ai_provider' => 'azure-openai',
+            'ai_provider' => $provider,
             'model_name' => $modelName,
             'ocr_text' => $ocrText,
             'raw_response_json' => $rawResponse,
@@ -2161,129 +2245,210 @@ class Diagnosis extends BaseController
      * @param array<int, array<string, mixed>> $visionImages
      * @return array<string, mixed>
      */
-    private function generateImagingDiagnosisDraft(string $studyName, array $ocrChunks, array $visionImages): array
+    private function generateImagingDiagnosisDraft(string $studyName, array $ocrChunks, array $visionImages, string $patientName = 'Unknown', int $patientAge = 0, string $patientGender = 'Unknown'): array
     {
-        $endpoint = rtrim($this->readSetting('AZURE_OPENAI_ENDPOINT'), '/');
+        if ($visionImages === []) {
-        $apiKey = trim($this->readSetting('AZURE_OPENAI_API_KEY'));
-        $deployment = trim($this->readSetting('AZURE_OPENAI_DEPLOYMENT'));
-        $apiVersion = trim($this->readSetting('AZURE_OPENAI_API_VERSION'));
-
-        if ($endpoint === '' || $apiKey === '' || $deployment === '') {
             return [
-                'error' => 'Azure OpenAI settings are missing for imaging AI diagnosis.',
+                'error' => 'No image available for AI diagnosis.',
             ];
         }
 
-        if ($apiVersion === '') {
+        $firstImagePath = (string) ($visionImages[0]['abs_path'] ?? '');
-            $apiVersion = '2024-10-21';
+        $firstImageMime = (string) ($visionImages[0]['mime'] ?? 'image/jpeg');
-        }
+        if ($firstImagePath === '' || ! is_file($firstImagePath)) {
-
-        if ($visionImages === [] && $ocrChunks === []) {
             return [
-                'error' => 'No image or OCR context available for AI diagnosis.',
+                'error' => 'Image file not found on server for AI diagnosis.',
             ];
         }
 
-        $content = [[
+        $response = $this->callAiServerDiagnosis($studyName, $firstImagePath, $firstImageMime, $patientName, $patientAge, $patientGender);
-            'type' => 'text',
+        if (($response['error'] ?? '') !== '') {
-            'text' => "You are assisting a radiologist in drafting an imaging report for an Indian hospital.\n" .
+            return $response;
-                "Study name: {$studyName}\n" .
-                "Review the uploaded imaging files and any OCR text.\n" .
-                "Return strict JSON only with keys: title, findings_html, impression_html, summary_text.\n" .
-                "Rules:\n" .
-                "1. findings_html must be concise HTML paragraphs or bullet list suitable for the report editor.\n" .
-                "2. impression_html must be concise HTML suitable for the Impression field.\n" .
-                "3. summary_text must be plain text under 220 characters.\n" .
-                "4. Do not include markdown fences.\n" .
-                "5. If image quality is poor, say that clearly in findings_html/impression_html.\n\n" .
-                ($ocrChunks !== [] ? ("OCR_CONTEXT:\n" . mb_substr(implode("\n\n", $ocrChunks), 0, 14000)) : 'OCR_CONTEXT: none'),
-        ]];
-
-        foreach ($visionImages as $imagePart) {
-            $content[] = $imagePart;
         }
 
-        $url = $endpoint . '/openai/deployments/' . rawurlencode($deployment) . '/chat/completions?api-version=' . rawurlencode($apiVersion);
+        $report = $response['report'] ?? [];
-        $attempts = $this->aiMaxRetries();
+        $technique = $this->normalizeAiTextValue($report['Technique'] ?? $studyName, $studyName);
-        $lastError = 'AI diagnosis generation failed.';
+        $impression = $this->normalizeAiTextValue($report['Impression'] ?? 'AI diagnosis draft prepared.', 'AI diagnosis draft prepared.');
 
-        for ($attempt = 1; $attempt <= $attempts; $attempt++) {
+        $findings = $report['Findings'] ?? [];
-            try {
+        $narrative = '';
-                $client = service('curlrequest', $this->httpOptions());
+        $labels = [];
-                $response = $client->post($url, [
+        $ocrText = [];
-                    'headers' => [
+        if (is_array($findings)) {
-                        'api-key' => $apiKey,
+            $narrative = $this->normalizeAiTextValue($findings['Narrative'] ?? '', '');
-                        'Content-Type' => 'application/json',
+            $labels = $this->normalizeAiListValue($findings['Labels'] ?? []);
-                    ],
+            $ocrText = $this->normalizeAiListValue($findings['OCR Text'] ?? []);
-                    'json' => [
+        } else {
-                        'messages' => [[
+            $narrative = $this->normalizeAiTextValue($findings, '');
-                            'role' => 'user',
+        }
-                            'content' => $content,
-                        ]],
-                        'temperature' => 0.2,
-                        'response_format' => ['type' => 'json_object'],
-                        'max_tokens' => 2200,
-                    ],
-                ]);
 
-                if ($response->getStatusCode() < 200 || $response->getStatusCode() >= 300) {
+        $labelHtml = '';
-                    $lastError = 'Azure OpenAI HTTP ' . $response->getStatusCode();
+        if ($labels !== []) {
-                    continue;
+            $safeLabels = array_slice(array_map(static fn($x) => trim((string) $x), $labels), 0, 8);
-                }
+            $safeLabels = array_values(array_filter($safeLabels, static fn($x) => $x !== ''));
-
+            if ($safeLabels !== []) {
-                $decoded = json_decode((string) $response->getBody(), true);
+                $labelHtml = '<p><strong>Detected labels:</strong> ' . esc(implode(', ', $safeLabels)) . '</p>';
-                $contentText = trim((string) ($decoded['choices'][0]['message']['content'] ?? ''));
-                if ($contentText === '') {
-                    $lastError = 'Azure OpenAI returned empty content.';
-                    continue;
-                }
-
-                $json = json_decode($contentText, true);
-                if (! is_array($json)) {
-                    $lastError = 'Azure OpenAI returned invalid JSON content.';
-                    continue;
-                }
-
-                $findingsHtml = trim((string) ($json['findings_html'] ?? ''));
-                $impressionHtml = trim((string) ($json['impression_html'] ?? ''));
-                if ($findingsHtml === '' && $impressionHtml === '') {
-                    $lastError = 'AI returned empty report sections.';
-                    continue;
-                }
-
-                return [
-                    'provider' => 'azure-openai',
-                    'model' => (string) ($decoded['model'] ?? $deployment),
-                    'title' => trim((string) ($json['title'] ?? $studyName)),
-                    'findings_html' => $findingsHtml,
-                    'impression_html' => $impressionHtml,
-                    'summary_text' => trim((string) ($json['summary_text'] ?? 'AI diagnosis draft prepared.')),
-                    'raw' => $decoded,
-                    'error' => '',
-                ];
-            } catch (\Throwable $e) {
-                $lastError = $e->getMessage() !== '' ? $e->getMessage() : 'Azure OpenAI request timeout/error.';
             }
         }
 
+        $ocrHtml = '';
+        if ($ocrText !== []) {
+            $ocrFirst = trim((string) ($ocrText[0] ?? ''));
+            if ($ocrFirst !== '') {
+                $ocrHtml = '<p><strong>OCR notes:</strong> ' . nl2br(esc(mb_substr($ocrFirst, 0, 1500))) . '</p>';
+            }
+        }
+
+        $findingsHtml = '<p><strong>Technique:</strong> ' . esc($technique) . '</p>';
+        if ($narrative !== '') {
+            $paragraphs = preg_split('/\R{2,}|\n/u', $narrative) ?: [];
+            $paragraphs = array_values(array_filter(array_map(static fn($item) => trim((string) $item), $paragraphs), static fn($item) => $item !== ''));
+            if ($paragraphs === []) {
+                $findingsHtml .= '<p>' . nl2br(esc($narrative)) . '</p>';
+            } else {
+                foreach ($paragraphs as $paragraph) {
+                    $findingsHtml .= '<p>' . esc($paragraph) . '</p>';
+                }
+            }
+        } else {
+            $findingsHtml .= $labelHtml . $ocrHtml;
+        }
+
         return [
-            'error' => $lastError,
+            'provider' => (string) ($response['provider'] ?? 'ai-server'),
+            'model' => (string) ($response['model'] ?? 'ai-server-diagnosis'),
+            'title' => trim((string) ($studyName !== '' ? $studyName : ($technique !== '' ? $technique : 'Imaging Study'))),
+            'findings_html' => $findingsHtml,
+            'impression_html' => '<p>' . esc($impression) . '</p>',
+            'summary_text' => mb_substr($impression !== '' ? $impression : 'AI diagnosis draft prepared.', 0, 220),
+            'raw' => $response['raw'] ?? [],
+            'error' => '',
         ];
     }
 
+    /**
+     * @param mixed $value
+     */
+    private function normalizeAiTextValue($value, string $fallback = ''): string
+    {
+        if (is_string($value)) {
+            $text = trim($value);
+            return $text !== '' ? $text : trim($fallback);
+        }
+
+        if (is_scalar($value)) {
+            $text = trim((string) $value);
+            return $text !== '' ? $text : trim($fallback);
+        }
+
+        if (is_array($value)) {
+            $chunks = [];
+            array_walk_recursive($value, static function ($item) use (&$chunks): void {
+                if (is_scalar($item)) {
+                    $text = trim((string) $item);
+                    if ($text !== '') {
+                        $chunks[] = $text;
+                    }
+                }
+            });
+
+            if ($chunks !== []) {
+                return trim(implode(' ', array_slice($chunks, 0, 8)));
+            }
+        }
+
+        return trim($fallback);
+    }
+
+    /**
+     * @param mixed $value
+     * @return array<int, string>
+     */
+    private function normalizeAiListValue($value): array
+    {
+        if (is_string($value)) {
+            $text = trim($value);
+            return $text !== '' ? [$text] : [];
+        }
+
+        if (is_scalar($value)) {
+            $text = trim((string) $value);
+            return $text !== '' ? [$text] : [];
+        }
+
+        if (! is_array($value)) {
+            return [];
+        }
+
+        $items = [];
+        array_walk_recursive($value, static function ($item) use (&$items): void {
+            if (is_scalar($item)) {
+                $text = trim((string) $item);
+                if ($text !== '') {
+                    $items[] = $text;
+                }
+            }
+        });
+
+        return array_slice($items, 0, 20);
+    }
+
     private function extractTextFromLabFile(string $absolutePath): string
     {
-        $docEndpoint = rtrim($this->readSetting('AZURE_DOCINTEL_ENDPOINT'), '/');
+        return $this->extractTextWithAiServerOcr($absolutePath);
-        $docKey = trim($this->readSetting('AZURE_DOCINTEL_KEY'));
+    }
 
-        if ($docEndpoint !== '' && $docKey !== '') {
+    private function extractTextWithAiServerOcr(string $absolutePath): string
-            $text = $this->extractTextWithDocumentIntelligence($absolutePath, $docEndpoint, $docKey);
+    {
-            if ($text !== '') {
+        $endpoint = rtrim($this->readSetting('DIAGNOSIS_AI_OCR_ENDPOINT'), '/');
-                return $text;
+        if ($endpoint === '') {
-            }
+            return '';
         }
 
-        return $this->extractTextWithAzureVisionLlm($absolutePath);
+        $mime = $this->detectMimeType($absolutePath);
+        if (! str_starts_with($mime, 'image/')) {
+            return '';
+        }
+
+        try {
+            $client = service('curlrequest', $this->httpOptions());
+            $headers = [
+                'Accept' => 'application/json',
+            ];
+
+            $token = trim($this->readSetting('DIAGNOSIS_AI_PARSE_TOKEN'));
+            if ($token !== '') {
+                $headers['Authorization'] = 'Bearer ' . $token;
+            }
+
+            $curlFile = new \CURLFile($absolutePath, $mime, basename($absolutePath));
+            $response = $client->post($endpoint, [
+                'headers' => $headers,
+                'multipart' => [
+                    'file' => $curlFile,
+                ],
+            ]);
+
+            if ($response->getStatusCode() < 200 || $response->getStatusCode() >= 300) {
+                return '';
+            }
+
+            $decoded = json_decode((string) $response->getBody(), true);
+            if (! is_array($decoded)) {
+                return '';
+            }
+
+            foreach (['ocr_text', 'text', 'extracted_text'] as $key) {
+                $value = trim((string) ($decoded[$key] ?? ''));
+                if ($value !== '') {
+                    return $value;
+                }
+            }
+        } catch (\Throwable $e) {
+            return '';
+        }
+
+        return '';
     }
 
     private function extractTextWithDocumentIntelligence(string $absolutePath, string $endpoint, string $key): string
@@ -2425,23 +2590,158 @@ class Diagnosis extends BaseController
         if (! empty($external['values']) && is_array($external['values'])) {
             return $external;
         }
-
-        $azure = $this->parseLabValuesWithAzureOpenAi($ocrText, $panelName);
-        if (! empty($azure['values']) && is_array($azure['values'])) {
-            return $azure;
-        }
-
         $externalError = trim((string) ($external['error'] ?? ''));
-        $azureError = trim((string) ($azure['error'] ?? ''));
         return [
             'provider' => 'none',
             'model' => '',
             'values' => [],
             'raw' => [],
-            'error' => $externalError !== '' ? $externalError : $azureError,
+            'error' => $externalError !== '' ? $externalError : 'AI parse failed. Configure DIAGNOSIS_AI_PARSE_ENDPOINT on your AI server.',
         ];
     }
 
+    /**
+     * @return array<string, mixed>
+     */
+    private function callAiServerDiagnosis(string $studyName, string $filePath, string $mime = 'image/jpeg', string $patientName = 'Unknown', int $patientAge = 0, string $patientGender = 'Unknown'): array
+    {
+        $base = $this->resolveAiServerBaseUrl();
+        if ($base === '') {
+            return [
+                'error' => 'AI server URL is missing. Configure DIAGNOSIS_AI_SERVER_URL or set parse/OCR endpoint in AI Settings.',
+            ];
+        }
+
+        if (! is_file($filePath)) {
+            return [
+                'error' => 'Image file not found: ' . basename($filePath),
+            ];
+        }
+
+        $isDicom = $this->isDicomMimeOrExtension($mime, strtolower(pathinfo($filePath, PATHINFO_EXTENSION)));
+        if ($isDicom) {
+            $ext = 'dcm';
+        } else {
+            $ext = str_contains($mime, 'png') ? 'png' : (str_contains($mime, 'webp') ? 'webp' : 'jpg');
+        }
+        $token = trim($this->readSetting('DIAGNOSIS_AI_PARSE_TOKEN'));
+        $headers = ['Accept' => 'application/json'];
+        if ($token !== '') {
+            $headers['Authorization'] = 'Bearer ' . $token;
+        }
+
+        $url = $base . '/diagnosis';
+        $prompt = $this->buildImagingDiagnosisPrompt($studyName);
+        $attempts = $this->aiMaxRetries();
+        $lastError = 'AI server diagnosis request failed.';
+
+        for ($attempt = 1; $attempt <= $attempts; $attempt++) {
+            try {
+                $client = service('curlrequest', $this->httpOptions());
+                $uploadMime = $isDicom ? 'application/dicom' : $mime;
+                $curlFile = new \CURLFile($filePath, $uploadMime, 'study.' . $ext);
+                $response = $client->post($url, [
+                    'headers' => $headers,
+                    'multipart' => [
+                        'file'               => $curlFile,
+                        'patient_name'       => $patientName !== '' ? $patientName : 'Unknown',
+                        'patient_age'        => (string) max(0, $patientAge),
+                        'patient_gender'     => $patientGender !== '' ? $patientGender : 'Unknown',
+                        'clinical_indication' => $studyName !== '' ? $studyName : 'Imaging study',
+                        'report_prompt'      => $prompt,
+                    ],
+                ]);
+
+                $status = $response->getStatusCode();
+                $body = (string) $response->getBody();
+                if ($status < 200 || $status >= 300) {
+                    $lastError = 'AI server HTTP ' . $status . ': ' . mb_substr($body, 0, 180);
+                    continue;
+                }
+
+                $decoded = json_decode($body, true);
+                if (! is_array($decoded)) {
+                    $lastError = 'AI server returned non-JSON response.';
+                    continue;
+                }
+
+                $report = $decoded['diagnosis_report'] ?? null;
+                if (! is_array($report)) {
+                    $lastError = trim((string) ($decoded['detail'] ?? 'AI server response missing diagnosis_report.'));
+                    continue;
+                }
+
+                return [
+                    'provider' => 'ai-server',
+                    'model' => 'python-fastapi',
+                    'report' => $report,
+                    'raw' => $decoded,
+                    'error' => '',
+                ];
+            } catch (\Throwable $e) {
+                $lastError = $e->getMessage() !== '' ? $e->getMessage() : 'AI server request timeout/error.';
+            }
+        }
+
+        return [
+            'error' => $lastError,
+        ];
+    }
+
+    private function buildImagingDiagnosisPrompt(string $studyName): string
+    {
+        $template = trim($this->readSetting('DIAGNOSIS_AI_IMAGING_PROMPT'));
+        if ($template === '') {
+            $template = "Generate a radiology report in concise clinical style.\n"
+                . "Use this structure exactly:\n"
+                . "1) Findings Draft\n"
+                . "2) Technique\n"
+                . "3) Impression Draft\n\n"
+                . "Include checks for lungs/pleura, mediastinum/heart size, diaphragm/costophrenic angles, bones/soft tissue, and lines/tubes/devices if present.\n"
+                . "If a structure is normal, explicitly state it as normal.\n"
+                . "Do not mention AI. Keep output clinically readable for doctors.\n"
+                . "Study Name: {study_name}";
+        }
+
+        $name = trim($studyName) !== '' ? trim($studyName) : 'Imaging study';
+        $prompt = str_replace(['{study_name}', '{{study_name}}'], $name, $template);
+
+        return trim($prompt);
+    }
+
+    private function resolveAiServerBaseUrl(): string
+    {
+        $base = rtrim($this->readSetting('DIAGNOSIS_AI_SERVER_URL'), '/');
+        if ($base !== '') {
+            return $base;
+        }
+
+        $candidateUrls = [
+            trim((string) $this->readSetting('DIAGNOSIS_AI_PARSE_ENDPOINT')),
+            trim((string) $this->readSetting('DIAGNOSIS_AI_OCR_ENDPOINT')),
+        ];
+
+        foreach ($candidateUrls as $url) {
+            if ($url === '') {
+                continue;
+            }
+
+            $parts = @parse_url($url);
+            if (! is_array($parts) || empty($parts['scheme']) || empty($parts['host'])) {
+                continue;
+            }
+
+            $base = (string) $parts['scheme'] . '://' . (string) $parts['host'];
+            if (! empty($parts['port'])) {
+                $base .= ':' . (int) $parts['port'];
+            }
+
+            return rtrim($base, '/');
+        }
+
+        return '';
+    }
+
     /**
      * @return array<string, mixed>
      */
@@ -2696,13 +2996,101 @@ class Diagnosis extends BaseController
                 'bmp' => 'image/bmp',
                 'gif' => 'image/gif',
                 'pdf' => 'application/pdf',
+                'dcm' => 'application/dicom',
+                'dicom' => 'application/dicom',
             ];
             $mime = $map[$ext] ?? 'application/octet-stream';
         }
 
+        if ($mime === 'application/octet-stream') {
+            $ext = strtolower(pathinfo($path, PATHINFO_EXTENSION));
+            if (in_array($ext, ['dcm', 'dicom'], true)) {
+                return 'application/dicom';
+            }
+        }
+
         return $mime;
     }
 
+    private function isDicomMimeOrExtension(string $mime, string $ext): bool
+    {
+        $mime = strtolower(trim($mime));
+        $ext = strtolower(trim($ext));
+
+        if (in_array($ext, ['dcm', 'dicom'], true)) {
+            return true;
+        }
+
+        return str_contains($mime, 'dicom');
+    }
+
+    /**
+     * @return array<string, mixed>
+     */
+    private function callAiServerDicomPreview(string $filePath, string $mime = 'application/dicom'): array
+    {
+        $base = $this->resolveAiServerBaseUrl();
+        if ($base === '') {
+            return [
+                'error' => 'AI server URL is missing for DICOM preview.',
+            ];
+        }
+
+        if (! is_file($filePath)) {
+            return [
+                'error' => 'DICOM file not found on server.',
+            ];
+        }
+
+        $token = trim($this->readSetting('DIAGNOSIS_AI_PARSE_TOKEN'));
+        $headers = ['Accept' => 'image/*'];
+        if ($token !== '') {
+            $headers['Authorization'] = 'Bearer ' . $token;
+        }
+
+        $url = $base . '/dicom-preview';
+        $attempts = $this->aiMaxRetries();
+        $lastError = 'DICOM preview request failed.';
+
+        for ($attempt = 1; $attempt <= $attempts; $attempt++) {
+            try {
+                $client = service('curlrequest', $this->httpOptions());
+                $curlFile = new \CURLFile($filePath, 'application/dicom', basename($filePath));
+                $response = $client->post($url, [
+                    'headers' => $headers,
+                    'multipart' => [
+                        'file' => $curlFile,
+                    ],
+                ]);
+
+                $status = $response->getStatusCode();
+                $body = (string) $response->getBody();
+                if ($status < 200 || $status >= 300) {
+                    $lastError = 'AI server HTTP ' . $status . ': ' . mb_substr($body, 0, 180);
+                    continue;
+                }
+
+                $contentType = strtolower(trim((string) $response->getHeaderLine('Content-Type')));
+                if (! str_starts_with($contentType, 'image/')) {
+                    $lastError = 'AI server did not return image data for DICOM preview.';
+                    continue;
+                }
+
+                return [
+                    'bytes' => $body,
+                    'mime' => $contentType,
+                    'error' => '',
+                ];
+            } catch (\Throwable $e) {
+                $lastError = $e->getMessage() !== '' ? $e->getMessage() : 'DICOM preview service timeout/error.';
+            }
+        }
+
+        return [
+            'error' => $lastError,
+        ];
+    }
+
     public function selectLabRadiology($invoiceId, $labType)
     {
         return $this->selectLabInvoicePath((int) $invoiceId, (int) $labType);

app/Controllers/Setting/AiSettings.php

@@ -12,21 +12,16 @@ class AiSettings extends BaseController
             return $this->response->setStatusCode(403)->setBody('Access denied');
         }
 
-        $geminiKey = $this->readSettingValue('GEMINI_API_KEY');
-        $azureKey = $this->readSettingValue('AZURE_OPENAI_API_KEY');
-        $docIntelKey = $this->readSettingValue('AZURE_DOCINTEL_KEY');
-
         return view('Setting/Admin/ai_settings', [
-            'gemini_key_masked' => $this->maskKey($geminiKey),
+            'diagnosis_ai_server_url' => $this->readSettingValue('DIAGNOSIS_AI_SERVER_URL'),
-            'gemini_key_exists' => $geminiKey !== '',
+            'diagnosis_ai_ocr_endpoint' => $this->readSettingValue('DIAGNOSIS_AI_OCR_ENDPOINT'),
-            'azure_openai_endpoint' => $this->readSettingValue('AZURE_OPENAI_ENDPOINT'),
+            'diagnosis_ai_parse_endpoint' => $this->readSettingValue('DIAGNOSIS_AI_PARSE_ENDPOINT'),
-            'azure_openai_deployment' => $this->readSettingValue('AZURE_OPENAI_DEPLOYMENT'),
+            'diagnosis_ai_imaging_prompt' => $this->readSettingValue('DIAGNOSIS_AI_IMAGING_PROMPT') ?: $this->defaultImagingPrompt(),
-            'azure_openai_api_version' => $this->readSettingValue('AZURE_OPENAI_API_VERSION') ?: '2024-10-21',
+            'diagnosis_ai_timeout_seconds' => $this->readSettingValue('DIAGNOSIS_AI_TIMEOUT_SECONDS') ?: '45',
-            'azure_openai_key_masked' => $this->maskKey($azureKey),
+            'diagnosis_ai_retry_attempts' => $this->readSettingValue('DIAGNOSIS_AI_RETRY_ATTEMPTS') ?: '2',
-            'azure_openai_key_exists' => $azureKey !== '',
+            'diagnosis_ai_daily_limit' => $this->readSettingValue('DIAGNOSIS_AI_DAILY_LIMIT') ?: '20',
-            'azure_docintel_endpoint' => $this->readSettingValue('AZURE_DOCINTEL_ENDPOINT'),
+            'diagnosis_ai_token_masked' => $this->maskKey($this->readSettingValue('DIAGNOSIS_AI_PARSE_TOKEN')),
-            'azure_docintel_key_masked' => $this->maskKey($docIntelKey),
+            'diagnosis_ai_token_exists' => $this->readSettingValue('DIAGNOSIS_AI_PARSE_TOKEN') !== '',
-            'azure_docintel_key_exists' => $docIntelKey !== '',
         ]);
     }
 
@@ -45,13 +40,14 @@ class AiSettings extends BaseController
         }
 
         $fields = [
-            'GEMINI_API_KEY' => trim((string) $this->request->getPost('gemini_api_key')),
+            'DIAGNOSIS_AI_SERVER_URL' => trim((string) $this->request->getPost('diagnosis_ai_server_url')),
-            'AZURE_OPENAI_ENDPOINT' => trim((string) $this->request->getPost('azure_openai_endpoint')),
+            'DIAGNOSIS_AI_OCR_ENDPOINT' => trim((string) $this->request->getPost('diagnosis_ai_ocr_endpoint')),
-            'AZURE_OPENAI_API_KEY' => trim((string) $this->request->getPost('azure_openai_api_key')),
+            'DIAGNOSIS_AI_PARSE_ENDPOINT' => trim((string) $this->request->getPost('diagnosis_ai_parse_endpoint')),
-            'AZURE_OPENAI_DEPLOYMENT' => trim((string) $this->request->getPost('azure_openai_deployment')),
+            'DIAGNOSIS_AI_IMAGING_PROMPT' => trim((string) $this->request->getPost('diagnosis_ai_imaging_prompt')),
-            'AZURE_OPENAI_API_VERSION' => trim((string) $this->request->getPost('azure_openai_api_version')),
+            'DIAGNOSIS_AI_PARSE_TOKEN' => trim((string) $this->request->getPost('diagnosis_ai_parse_token')),
-            'AZURE_DOCINTEL_ENDPOINT' => trim((string) $this->request->getPost('azure_docintel_endpoint')),
+            'DIAGNOSIS_AI_TIMEOUT_SECONDS' => trim((string) $this->request->getPost('diagnosis_ai_timeout_seconds')),
-            'AZURE_DOCINTEL_KEY' => trim((string) $this->request->getPost('azure_docintel_key')),
+            'DIAGNOSIS_AI_RETRY_ATTEMPTS' => trim((string) $this->request->getPost('diagnosis_ai_retry_attempts')),
+            'DIAGNOSIS_AI_DAILY_LIMIT' => trim((string) $this->request->getPost('diagnosis_ai_daily_limit')),
         ];
 
         $savedCount = 0;
@@ -94,163 +90,193 @@ class AiSettings extends BaseController
 
         $provider = strtolower(trim((string) $this->request->getPost('provider')));
         if ($provider === '') {
-            $provider = 'gemini';
+            $provider = 'ai-server';
         }
 
-        if ($provider === 'azure') {
+        if ($provider === 'diagnosis-external') {
-            return $this->testAzureOpenAi();
+            return $this->testDiagnosisExternalAi();
         }
 
-        $apiKey = trim((string) $this->request->getPost('gemini_api_key'));
+        if ($provider === 'ai-server') {
-        if ($apiKey === '') {
+            return $this->testAiServer();
-            $apiKey = $this->readSettingValue('GEMINI_API_KEY');
         }
 
-        if ($apiKey === '') {
+        return $this->response->setJSON([
-            return $this->response->setJSON(['update' => 0, 'error_text' => 'Gemini API key not configured']);
+            'update' => 0,
-        }
+            'error_text' => 'Unsupported provider',
-
+            'csrfName' => csrf_token(),
-        try {
+            'csrfHash' => csrf_hash(),
-            $client = service('curlrequest', $this->geminiHttpOptions());
+        ]);
-            $payload = [
-                'contents' => [[
-                    'parts' => [[
-                        'text' => 'Reply with exactly: CONNECTED',
-                    ]],
-                ]],
-                'generationConfig' => [
-                    'temperature' => 0,
-                    'maxOutputTokens' => 20,
-                ],
-            ];
-
-            $lastStatus = 0;
-            $lastBody = '';
-
-            foreach ($this->geminiModelCandidates() as $modelName) {
-                $url = 'https://generativelanguage.googleapis.com/v1beta/models/' . $modelName . ':generateContent?key=' . urlencode($apiKey);
-                $response = $client->post($url, [
-                    'headers' => ['Content-Type' => 'application/json'],
-                    'json' => $payload,
-                ]);
-
-                $status = $response->getStatusCode();
-                $body = (string) $response->getBody();
-
-                if ($status === 429) {
-                    usleep(1200000);
-                    $retry = $client->post($url, [
-                        'headers' => ['Content-Type' => 'application/json'],
-                        'json' => $payload,
-                    ]);
-                    $status = $retry->getStatusCode();
-                    $body = (string) $retry->getBody();
-                }
-
-                if ($status >= 200 && $status < 300) {
-                    return $this->response->setJSON([
-                        'update' => 1,
-                        'error_text' => 'Gemini connection successful (' . $modelName . ')',
-                        'csrfName' => csrf_token(),
-                        'csrfHash' => csrf_hash(),
-                    ]);
-                }
-
-                $lastStatus = $status;
-                $lastBody = $body;
-
-                if ($status !== 404) {
-                    break;
-                }
-            }
-
-            return $this->response->setJSON([
-                'update' => 0,
-                'error_text' => $this->geminiHttpFailureMessage($lastStatus, $lastBody),
-                'detail' => mb_substr($lastBody, 0, 250),
-                'csrfName' => csrf_token(),
-                'csrfHash' => csrf_hash(),
-            ]);
-        } catch (\Throwable $e) {
-            return $this->response->setJSON([
-                'update' => 0,
-                'error_text' => $this->normalizeGeminiError($e->getMessage()),
-                'csrfName' => csrf_token(),
-                'csrfHash' => csrf_hash(),
-            ]);
-        }
     }
 
-    private function testAzureOpenAi()
+    public function usage()
     {
-        $endpoint = trim((string) $this->request->getPost('azure_openai_endpoint'));
+        if (! $this->request->isAJAX()) {
-        $apiKey = trim((string) $this->request->getPost('azure_openai_api_key'));
+            return $this->response->setJSON(['update' => 0, 'error_text' => 'Invalid request']);
-        $deployment = trim((string) $this->request->getPost('azure_openai_deployment'));
-        $apiVersion = trim((string) $this->request->getPost('azure_openai_api_version'));
-
-        if ($endpoint === '') {
-            $endpoint = $this->readSettingValue('AZURE_OPENAI_ENDPOINT');
-        }
-        if ($apiKey === '') {
-            $apiKey = $this->readSettingValue('AZURE_OPENAI_API_KEY');
-        }
-        if ($deployment === '') {
-            $deployment = $this->readSettingValue('AZURE_OPENAI_DEPLOYMENT');
-        }
-        if ($apiVersion === '') {
-            $apiVersion = $this->readSettingValue('AZURE_OPENAI_API_VERSION');
-        }
-        if ($apiVersion === '') {
-            $apiVersion = '2024-10-21';
         }
 
-        if ($endpoint === '' || $apiKey === '' || $deployment === '') {
+        if (! $this->canManageAiSettings()) {
-            $missing = [];
+            return $this->response->setStatusCode(403)->setJSON(['update' => 0, 'error_text' => 'Access denied']);
-            if ($endpoint === '') {
+        }
-                $missing[] = 'endpoint';
-            }
-            if ($apiKey === '') {
-                $missing[] = 'key';
-            }
-            if ($deployment === '') {
-                $missing[] = 'deployment';
-            }
 
+        if (! $this->db->tableExists('lab_ai_extraction_batches')) {
             return $this->response->setJSON([
-                'update' => 0,
+                'update' => 1,
-                'error_text' => 'Azure OpenAI settings incomplete: missing ' . implode(', ', $missing),
+                'error_text' => 'Usage table unavailable',
+                'usage' => [
+                    'total_today' => 0,
+                    'gemini_today' => 0,
+                    'fallback_today' => 0,
+                    'last_hour' => 0,
+                    'daily_limit' => 20,
+                    'level' => 'ok',
+                    'ratio' => 0,
+                    'providers' => [],
+                ],
                 'csrfName' => csrf_token(),
                 'csrfHash' => csrf_hash(),
             ]);
         }
 
-        $endpoint = rtrim($endpoint, '/');
+        $dailyLimit = (int) ($this->readSettingValue('DIAGNOSIS_AI_DAILY_LIMIT') ?: '20');
-        $url = $endpoint . '/openai/deployments/' . rawurlencode($deployment) . '/chat/completions?api-version=' . rawurlencode($apiVersion);
+        if ($dailyLimit <= 0) {
+            $dailyLimit = 20;
+        }
+
+        $start = date('Y-m-d 00:00:00');
+        $end = date('Y-m-d 23:59:59');
+        $hourStart = date('Y-m-d H:i:s', time() - 3600);
+
+        $table = $this->db->table('lab_ai_extraction_batches');
+
+        $totalToday = (int) $this->db->table('lab_ai_extraction_batches')
+            ->where('created_at >=', $start)
+            ->where('created_at <=', $end)
+            ->countAllResults();
+
+        $geminiToday = (int) $this->db->table('lab_ai_extraction_batches')
+            ->where('created_at >=', $start)
+            ->where('created_at <=', $end)
+            ->where("LOWER(ai_provider) = 'gemini'", null, false)
+            ->countAllResults();
+
+        $fallbackToday = (int) $this->db->table('lab_ai_extraction_batches')
+            ->where('created_at >=', $start)
+            ->where('created_at <=', $end)
+            ->where("LOWER(ai_provider) IN ('local-xray-fallback','regex-fallback')", null, false)
+            ->countAllResults();
+
+        $lastHour = (int) $this->db->table('lab_ai_extraction_batches')
+            ->where('created_at >=', $hourStart)
+            ->where('created_at <=', $end)
+            ->countAllResults();
+
+        $providerRows = $table
+            ->select('ai_provider, COUNT(*) AS total', false)
+            ->where('created_at >=', $start)
+            ->where('created_at <=', $end)
+            ->groupBy('ai_provider')
+            ->orderBy('total', 'DESC')
+            ->get()
+            ->getResultArray();
+
+        $providers = [];
+        foreach ($providerRows as $row) {
+            $key = trim((string) ($row['ai_provider'] ?? ''));
+            if ($key === '') {
+                $key = 'unknown';
+            }
+            $providers[] = [
+                'provider' => $key,
+                'count' => (int) ($row['total'] ?? 0),
+            ];
+        }
+
+        $ratio = (int) round(($geminiToday / max(1, $dailyLimit)) * 100);
+        $level = 'ok';
+        if ($ratio >= 100) {
+            $level = 'critical';
+        } elseif ($ratio >= 90) {
+            $level = 'danger';
+        } elseif ($ratio >= 70) {
+            $level = 'warn';
+        }
+
+        return $this->response->setJSON([
+            'update' => 1,
+            'usage' => [
+                'total_today' => $totalToday,
+                'gemini_today' => $geminiToday,
+                'fallback_today' => $fallbackToday,
+                'last_hour' => $lastHour,
+                'daily_limit' => $dailyLimit,
+                'level' => $level,
+                'ratio' => $ratio,
+                'providers' => $providers,
+            ],
+            'csrfName' => csrf_token(),
+            'csrfHash' => csrf_hash(),
+        ]);
+    }
+
+    private function testDiagnosisExternalAi()
+    {
+        $endpoint = trim((string) $this->request->getPost('diagnosis_ai_parse_endpoint'));
+        $token = trim((string) $this->request->getPost('diagnosis_ai_parse_token'));
+
+        if ($endpoint === '') {
+            $endpoint = $this->readSettingValue('DIAGNOSIS_AI_PARSE_ENDPOINT');
+        }
+        if ($token === '') {
+            $token = $this->readSettingValue('DIAGNOSIS_AI_PARSE_TOKEN');
+        }
+
+        if ($endpoint === '') {
+            return $this->response->setJSON([
+                'update' => 0,
+                'error_text' => 'Diagnosis AI endpoint is required',
+                'csrfName' => csrf_token(),
+                'csrfHash' => csrf_hash(),
+            ]);
+        }
 
         try {
+            $headers = [
+                'Content-Type' => 'application/json',
+                'Accept' => 'application/json',
+            ];
+            if ($token !== '') {
+                $headers['Authorization'] = 'Bearer ' . $token;
+            }
+
             $client = service('curlrequest', $this->geminiHttpOptions());
-            $response = $client->post($url, [
+            $response = $client->post(rtrim($endpoint, '/'), [
-                'headers' => [
+                'headers' => $headers,
-                    'api-key' => $apiKey,
-                    'Content-Type' => 'application/json',
-                ],
                 'json' => [
-                    'messages' => [[
+                    'ocr_text' => 'Hemoglobin 13.5 g/dL; Total Bilirubin 1.2 mg/dL',
-                        'role' => 'user',
+                    'panel_name' => 'LFT Test',
-                        'content' => 'Reply with exactly: CONNECTED',
-                    ]],
-                    'temperature' => 0,
-                    'max_tokens' => 20,
                 ],
             ]);
 
             $status = $response->getStatusCode();
             $body = (string) $response->getBody();
+            $decoded = json_decode($body, true);
 
             if ($status < 200 || $status >= 300) {
                 return $this->response->setJSON([
                     'update' => 0,
-                    'error_text' => 'Azure OpenAI test failed (HTTP ' . $status . ')',
+                    'error_text' => 'Diagnosis AI endpoint test failed (HTTP ' . $status . ')',
+                    'detail' => mb_substr($body, 0, 300),
+                    'csrfName' => csrf_token(),
+                    'csrfHash' => csrf_hash(),
+                ]);
+            }
+
+            $values = $decoded['values'] ?? null;
+            if (! is_array($values)) {
+                return $this->response->setJSON([
+                    'update' => 0,
+                    'error_text' => 'Diagnosis AI endpoint responded without values[]',
                     'detail' => mb_substr($body, 0, 300),
                     'csrfName' => csrf_token(),
                     'csrfHash' => csrf_hash(),
@@ -259,14 +285,76 @@ class AiSettings extends BaseController
 
             return $this->response->setJSON([
                 'update' => 1,
-                'error_text' => 'Azure OpenAI connection successful',
+                'error_text' => 'Diagnosis AI endpoint connection successful',
                 'csrfName' => csrf_token(),
                 'csrfHash' => csrf_hash(),
             ]);
         } catch (\Throwable $e) {
             return $this->response->setJSON([
                 'update' => 0,
-                'error_text' => 'Azure OpenAI test failed: ' . $e->getMessage(),
+                'error_text' => 'Diagnosis AI endpoint test failed: ' . $e->getMessage(),
+                'csrfName' => csrf_token(),
+                'csrfHash' => csrf_hash(),
+            ]);
+        }
+    }
+
+    private function testAiServer()
+    {
+        $baseUrl = trim((string) $this->request->getPost('diagnosis_ai_server_url'));
+        if ($baseUrl === '') {
+            $baseUrl = $this->readSettingValue('DIAGNOSIS_AI_SERVER_URL');
+        }
+
+        if ($baseUrl === '') {
+            return $this->response->setJSON([
+                'update' => 0,
+                'error_text' => 'AI Server URL is required',
+                'csrfName' => csrf_token(),
+                'csrfHash' => csrf_hash(),
+            ]);
+        }
+
+        $token = trim((string) $this->request->getPost('diagnosis_ai_parse_token'));
+        if ($token === '') {
+            $token = $this->readSettingValue('DIAGNOSIS_AI_PARSE_TOKEN');
+        }
+
+        try {
+            $headers = ['Accept' => 'application/json'];
+            if ($token !== '') {
+                $headers['Authorization'] = 'Bearer ' . $token;
+            }
+
+            $client = service('curlrequest', $this->geminiHttpOptions());
+            $url = rtrim($baseUrl, '/') . '/translate?text=test&target_lang=en';
+            $response = $client->get($url, [
+                'headers' => $headers,
+            ]);
+
+            $status = $response->getStatusCode();
+            $body = (string) $response->getBody();
+
+            if ($status < 200 || $status >= 300) {
+                return $this->response->setJSON([
+                    'update' => 0,
+                    'error_text' => 'AI Server test failed (HTTP ' . $status . ')',
+                    'detail' => mb_substr($body, 0, 300),
+                    'csrfName' => csrf_token(),
+                    'csrfHash' => csrf_hash(),
+                ]);
+            }
+
+            return $this->response->setJSON([
+                'update' => 1,
+                'error_text' => 'AI Server connection successful',
+                'csrfName' => csrf_token(),
+                'csrfHash' => csrf_hash(),
+            ]);
+        } catch (\Throwable $e) {
+            return $this->response->setJSON([
+                'update' => 0,
+                'error_text' => 'AI Server test failed: ' . $e->getMessage(),
                 'csrfName' => csrf_token(),
                 'csrfHash' => csrf_hash(),
             ]);
@@ -290,57 +378,6 @@ class AiSettings extends BaseController
         return $options;
     }
 
-    private function normalizeGeminiError(string $message): string
-    {
-        $message = trim($message);
-
-        if (stripos($message, 'SSL certificate problem') !== false) {
-            return 'Gemini test failed: SSL certificate trust issue in local PHP/cURL. Local use is possible; this build auto-relaxes SSL only in development/testing. If still failing, configure CA bundle in PHP.';
-        }
-
-        return 'Gemini test failed: ' . $message;
-    }
-
-    private function geminiHttpFailureMessage(int $status, string $body): string
-    {
-        if ($status === 429) {
-            return 'Gemini test failed: Rate limit/quota exceeded (HTTP 429). Please wait 1-2 minutes, then retry. If it continues, check API quota/billing in Google AI Studio.';
-        }
-
-        if ($status === 403) {
-            return 'Gemini test failed: API key not permitted for this request (HTTP 403). Verify key and project permissions.';
-        }
-
-        if ($status === 404) {
-            return 'Gemini test failed: Model endpoint not found (HTTP 404). Please verify Gemini API availability for this key/project.';
-        }
-
-        if ($status <= 0) {
-            return 'Gemini test failed: No HTTP response received.';
-        }
-
-        $message = 'Gemini test failed (HTTP ' . $status . ')';
-        $decoded = json_decode($body, true);
-        $apiMessage = trim((string) ($decoded['error']['message'] ?? ''));
-        if ($apiMessage !== '') {
-            $message .= ': ' . $apiMessage;
-        }
-
-        return $message;
-    }
-
-    /**
-     * @return array<int, string>
-     */
-    private function geminiModelCandidates(): array
-    {
-        return [
-            'gemini-2.0-flash',
-            'gemini-1.5-flash',
-            'gemini-1.5-flash-latest',
-        ];
-    }
-
     private function canManageAiSettings(): bool
     {
         if (! function_exists('auth') || ! auth()->loggedIn()) {
@@ -350,6 +387,19 @@ class AiSettings extends BaseController
         return true;
     }
 
+    private function defaultImagingPrompt(): string
+    {
+        return "Generate a radiology report in concise clinical style.\n"
+            . "Use this structure exactly:\n"
+            . "1) Findings Draft\n"
+            . "2) Technique\n"
+            . "3) Impression Draft\n\n"
+            . "Include checks for lungs/pleura, mediastinum/heart size, diaphragm/costophrenic angles, bones/soft tissue, and lines/tubes/devices if present.\n"
+            . "If a structure is normal, explicitly state it as normal.\n"
+            . "Do not mention AI. Keep output clinically readable for doctors.\n"
+            . "Study Name: {study_name}";
+    }
+
     private function readSettingValue(string $name): string
     {
         if (defined($name)) {

app/Views/Setting/Admin/ai_settings.php

@@ -5,84 +5,88 @@
     <div class="card-body">
         <?= csrf_field() ?>
 
-        <h6 class="mb-2">Gemini (optional fallback)</h6>
+        <h6 class="mb-2">AI Server (Primary - Python FastAPI)</h6>
-
         <div class="mb-3">
-            <label class="form-label">Gemini API Key</label>
+            <label class="form-label">AI Server Base URL</label>
-            <input type="password" class="form-control" id="gemini_api_key" placeholder="Paste Gemini API key">
+            <input type="text" class="form-control" id="diagnosis_ai_server_url" placeholder="http://127.0.0.1:8000" value="<?= esc($diagnosis_ai_server_url ?? '') ?>">
-            <div class="form-text">
+            <div class="form-text">Used for imaging diagnosis endpoint: /diagnosis</div>
-                <?php if (!empty($gemini_key_exists)) : ?>
+        </div>
-                    Current key: <?= esc($gemini_key_masked ?? '') ?>
+        <div class="mb-3">
-                <?php else : ?>
+            <label class="form-label">AI OCR Endpoint (optional, for pathology file OCR)</label>
-                    No API key configured yet.
+            <input type="text" class="form-control" id="diagnosis_ai_ocr_endpoint" placeholder="http://127.0.0.1:8000/ocr" value="<?= esc($diagnosis_ai_ocr_endpoint ?? '') ?>">
-                <?php endif; ?>
+            <div class="form-text">If not configured, pathology AI extraction OCR will be unavailable.</div>
-            </div>
         </div>
 
-        <div class="alert alert-info">
+        <div class="mb-3">
-            <h6 class="mb-2">How to get Gemini API key</h6>
+            <label class="form-label">Imaging Report Prompt Template <span class="badge bg-secondary">Optional Override</span></label>
-            <ol class="mb-2 ps-3">
+            <textarea class="form-control" id="diagnosis_ai_imaging_prompt" rows="6" placeholder="Leave empty to use auto-detected prompts per study type. Use {study_name} as placeholder."><?= esc($diagnosis_ai_imaging_prompt ?? '') ?></textarea>
-                <li>
+            <div class="form-text">
-                    Open <a href="https://aistudio.google.com/app/apikey" target="_blank" rel="noopener">Google AI Studio API Keys</a>
+                <strong>Auto-detection is active:</strong> the server automatically selects the correct prompt structure for each study type —
-                    <button type="button" class="btn btn-sm btn-outline-secondary ms-2" id="btn_copy_gemini_link" data-url="https://aistudio.google.com/app/apikey">Copy Link</button>.
+                Chest X-ray, Abdomen, Spine, PNS/Sinuses, Skull, Pelvis, Extremities/Joints, Contrast studies, Mammography, MRI, CT, Ultrasound.<br>
-                </li>
+                Fill this field only to override with a custom global prompt for all studies. Use <code>{study_name}</code> as placeholder for current study name. Leave blank to keep auto-detection.
-                <li>Sign in and click <strong>Create API key</strong>.</li>
+            </div>
-                <li>Copy the key and paste it in this field.</li>
-                <li>Click <strong>Save Key</strong>, then <strong>Test Connection</strong>.</li>
-            </ol>
-            <div class="small mb-0">If test fails, check internet access from server, remove extra spaces/newline in key, or regenerate key.</div>
         </div>
 
         <hr>
-        <h6 class="mb-2">Azure OpenAI (Primary)</h6>
+        <h6 class="mb-2">Diagnosis AI Parse Endpoint</h6>
         <div class="mb-3">
-            <label class="form-label">Azure OpenAI Endpoint</label>
+            <label class="form-label">Diagnosis Parse Endpoint</label>
-            <input type="text" class="form-control" id="azure_openai_endpoint" placeholder="https://your-resource.openai.azure.com" value="<?= esc($azure_openai_endpoint ?? '') ?>">
+            <input type="text" class="form-control" id="diagnosis_ai_parse_endpoint" placeholder="http://127.0.0.1:8000/parse-lab-values" value="<?= esc($diagnosis_ai_parse_endpoint ?? '') ?>">
+            <div class="form-text">Used by pathology value extraction flow.</div>
         </div>
+
         <div class="mb-3">
-            <label class="form-label">Azure OpenAI API Key</label>
+            <label class="form-label">Diagnosis Parse Token (optional)</label>
-            <input type="password" class="form-control" id="azure_openai_api_key" placeholder="Paste Azure OpenAI key">
+            <input type="password" class="form-control" id="diagnosis_ai_parse_token" placeholder="Bearer token">
             <div class="form-text">
-                <?php if (!empty($azure_openai_key_exists)) : ?>
+                <?php if (!empty($diagnosis_ai_token_exists)) : ?>
-                    Current key: <?= esc($azure_openai_key_masked ?? '') ?>
+                    Current token: <?= esc($diagnosis_ai_token_masked ?? '') ?>
                 <?php else : ?>
-                    No Azure OpenAI key configured yet.
+                    No token configured yet.
                 <?php endif; ?>
             </div>
         </div>
+
         <div class="row">
             <div class="col-md-6 mb-3">
-                <label class="form-label">Deployment Name</label>
+                <label class="form-label">Diagnosis AI Timeout (seconds)</label>
-                <input type="text" class="form-control" id="azure_openai_deployment" placeholder="hms-opd-draft" value="<?= esc($azure_openai_deployment ?? '') ?>">
+                <input type="number" min="5" max="180" class="form-control" id="diagnosis_ai_timeout_seconds" value="<?= esc($diagnosis_ai_timeout_seconds ?? '45') ?>">
             </div>
             <div class="col-md-6 mb-3">
-                <label class="form-label">API Version</label>
+                <label class="form-label">Diagnosis AI Retry Attempts</label>
-                <input type="text" class="form-control" id="azure_openai_api_version" placeholder="2024-10-21" value="<?= esc($azure_openai_api_version ?? '2024-10-21') ?>">
+                <input type="number" min="1" max="5" class="form-control" id="diagnosis_ai_retry_attempts" value="<?= esc($diagnosis_ai_retry_attempts ?? '2') ?>">
             </div>
         </div>
 
-        <hr>
+        <div class="row">
-        <h6 class="mb-2">OCR (Azure Document Intelligence)</h6>
+            <div class="col-md-6 mb-3">
-        <div class="mb-3">
+                <label class="form-label">Gemini Daily Limit (guardrail)</label>
-            <label class="form-label">Document Intelligence Endpoint</label>
+                <input type="number" min="1" max="10000" class="form-control" id="diagnosis_ai_daily_limit" value="<?= esc($diagnosis_ai_daily_limit ?? '20') ?>">
-            <input type="text" class="form-control" id="azure_docintel_endpoint" placeholder="https://your-docintel.cognitiveservices.azure.com" value="<?= esc($azure_docintel_endpoint ?? '') ?>">
+                <div class="form-text">Used for warning levels at 70% and 90%.</div>
-        </div>
-        <div class="mb-3">
-            <label class="form-label">Document Intelligence Key</label>
-            <input type="password" class="form-control" id="azure_docintel_key" placeholder="Paste Document Intelligence key">
-            <div class="form-text">
-                <?php if (!empty($azure_docintel_key_exists)) : ?>
-                    Current key: <?= esc($azure_docintel_key_masked ?? '') ?>
-                <?php else : ?>
-                    No Document Intelligence key configured yet.
-                <?php endif; ?>
             </div>
+            <div class="col-md-6 mb-3 d-flex align-items-end">
+                <button type="button" class="btn btn-outline-primary" id="btn_refresh_ai_usage">Refresh Usage</button>
+            </div>
+        </div>
+
+        <div class="border rounded p-3 mb-3 bg-light" id="ai_usage_card">
+            <div class="d-flex justify-content-between align-items-center mb-2">
+                <strong>AI Usage Guardrail (Today)</strong>
+                <span class="badge bg-secondary" id="ai_usage_level">Unknown</span>
+            </div>
+            <div class="row g-2">
+                <div class="col-md-3"><div class="small text-muted">Gemini Calls</div><div id="ai_usage_gemini" class="fw-bold">-</div></div>
+                <div class="col-md-3"><div class="small text-muted">Fallback Calls</div><div id="ai_usage_fallback" class="fw-bold">-</div></div>
+                <div class="col-md-3"><div class="small text-muted">Total Calls</div><div id="ai_usage_total" class="fw-bold">-</div></div>
+                <div class="col-md-3"><div class="small text-muted">Last Hour</div><div id="ai_usage_hour" class="fw-bold">-</div></div>
+            </div>
+            <div class="small mt-2 text-muted" id="ai_usage_hint">Press Refresh Usage to load latest usage.</div>
         </div>
 
         <div class="d-flex gap-2 flex-wrap">
             <button type="button" class="btn btn-primary" id="btn_save_ai_key">Save Settings</button>
-            <button type="button" class="btn btn-outline-success" id="btn_test_ai_key">Test Gemini</button>
+            <button type="button" class="btn btn-outline-dark" id="btn_test_ai_server">Test AI Server</button>
-            <button type="button" class="btn btn-outline-primary" id="btn_test_azure_key">Test Azure OpenAI</button>
+            <button type="button" class="btn btn-outline-secondary" id="btn_test_diagnosis_ai">Test Parse Endpoint</button>
         </div>
 
         <div id="ai_settings_msg" class="mt-3"></div>
@@ -129,99 +133,105 @@
     }
 
     $('#btn_save_ai_key').on('click', function() {
-        var key = ($('#gemini_api_key').val() || '').trim();
+        var aiServerUrl = ($('#diagnosis_ai_server_url').val() || '').trim();
-        var azureEndpoint = ($('#azure_openai_endpoint').val() || '').trim();
+        var aiOcrEndpoint = ($('#diagnosis_ai_ocr_endpoint').val() || '').trim();
-        var azureKey = ($('#azure_openai_api_key').val() || '').trim();
+        var diagnosisEndpoint = ($('#diagnosis_ai_parse_endpoint').val() || '').trim();
-        var azureDeployment = ($('#azure_openai_deployment').val() || '').trim();
+        var diagnosisImagingPrompt = ($('#diagnosis_ai_imaging_prompt').val() || '').trim();
-        var azureApiVersion = ($('#azure_openai_api_version').val() || '').trim();
+        var diagnosisToken = ($('#diagnosis_ai_parse_token').val() || '').trim();
-        var docintelEndpoint = ($('#azure_docintel_endpoint').val() || '').trim();
+        var diagnosisTimeout = ($('#diagnosis_ai_timeout_seconds').val() || '').trim();
-        var docintelKey = ($('#azure_docintel_key').val() || '').trim();
+        var diagnosisRetry = ($('#diagnosis_ai_retry_attempts').val() || '').trim();
 
         postJson('<?= base_url('setting/admin/ai-settings/save') ?>', {
-            gemini_api_key: key,
+            diagnosis_ai_server_url: aiServerUrl,
-            azure_openai_endpoint: azureEndpoint,
+            diagnosis_ai_ocr_endpoint: aiOcrEndpoint,
-            azure_openai_api_key: azureKey,
+            diagnosis_ai_parse_endpoint: diagnosisEndpoint,
-            azure_openai_deployment: azureDeployment,
+            diagnosis_ai_imaging_prompt: diagnosisImagingPrompt,
-            azure_openai_api_version: azureApiVersion,
+            diagnosis_ai_parse_token: diagnosisToken,
-            azure_docintel_endpoint: docintelEndpoint,
+            diagnosis_ai_timeout_seconds: diagnosisTimeout,
-            azure_docintel_key: docintelKey
+            diagnosis_ai_retry_attempts: diagnosisRetry,
+            diagnosis_ai_daily_limit: ($('#diagnosis_ai_daily_limit').val() || '').trim()
         }, function(data) {
             if ((data.update || 0) !== 1) {
-                showMessage('error', data.error_text || 'Unable to save API key');
+                showMessage('error', data.error_text || 'Unable to save settings');
                 return;
             }
 
             showMessage('success', data.error_text || 'Settings saved');
-            $('#gemini_api_key').val('');
+            $('#diagnosis_ai_parse_token').val('');
-            $('#azure_openai_api_key').val('');
+            refreshUsage();
-            $('#azure_docintel_key').val('');
         });
     });
 
-    $('#btn_test_ai_key').on('click', function() {
+    $('#btn_test_ai_server').on('click', function() {
-        var key = ($('#gemini_api_key').val() || '').trim();
+        var aiServerUrl = ($('#diagnosis_ai_server_url').val() || '').trim();
-        postJson('<?= base_url('setting/admin/ai-settings/test') ?>', {
+        var diagnosisToken = ($('#diagnosis_ai_parse_token').val() || '').trim();
-            provider: 'gemini',
-            gemini_api_key: key
-        }, function(data) {
-            if ((data.update || 0) !== 1) {
-                showMessage('error', data.error_text || 'Test failed');
-                return;
-            }
-            showMessage('success', data.error_text || 'Connection successful');
-        });
-    });
-
-    $('#btn_test_azure_key').on('click', function() {
-        var azureEndpoint = ($('#azure_openai_endpoint').val() || '').trim();
-        var azureKey = ($('#azure_openai_api_key').val() || '').trim();
-        var azureDeployment = ($('#azure_openai_deployment').val() || '').trim();
-        var azureApiVersion = ($('#azure_openai_api_version').val() || '').trim();
 
         postJson('<?= base_url('setting/admin/ai-settings/test') ?>', {
-            provider: 'azure',
+            provider: 'ai-server',
-            azure_openai_endpoint: azureEndpoint,
+            diagnosis_ai_server_url: aiServerUrl,
-            azure_openai_api_key: azureKey,
+            diagnosis_ai_parse_token: diagnosisToken
-            azure_openai_deployment: azureDeployment,
-            azure_openai_api_version: azureApiVersion
         }, function(data) {
             if ((data.update || 0) !== 1) {
-                showMessage('error', data.error_text || 'Azure test failed');
+                showMessage('error', data.error_text || 'AI Server test failed');
                 return;
             }
-            showMessage('success', data.error_text || 'Azure connection successful');
+            showMessage('success', data.error_text || 'AI Server connection successful');
         });
     });
 
-    $('#btn_copy_gemini_link').on('click', function() {
+    $('#btn_test_diagnosis_ai').on('click', function() {
-        var url = $(this).data('url') || '';
+        var diagnosisEndpoint = ($('#diagnosis_ai_parse_endpoint').val() || '').trim();
-        if (!url) {
+        var diagnosisToken = ($('#diagnosis_ai_parse_token').val() || '').trim();
-            showMessage('error', 'Unable to copy link');
-            return;
-        }
 
-        if (navigator.clipboard && navigator.clipboard.writeText) {
+        postJson('<?= base_url('setting/admin/ai-settings/test') ?>', {
-            navigator.clipboard.writeText(url).then(function() {
+            provider: 'diagnosis-external',
-                showMessage('success', 'Gemini link copied');
+            diagnosis_ai_parse_endpoint: diagnosisEndpoint,
-            }).catch(function() {
+            diagnosis_ai_parse_token: diagnosisToken
-                showMessage('error', 'Copy failed. Please copy manually');
+        }, function(data) {
-            });
+            if ((data.update || 0) !== 1) {
-            return;
+                showMessage('error', data.error_text || 'Parse endpoint test failed');
-        }
+                return;
-
+            }
-        var temp = document.createElement('input');
+            showMessage('success', data.error_text || 'Parse endpoint connection successful');
-        temp.value = url;
+        });
-        document.body.appendChild(temp);
-        temp.select();
-
-        try {
-            document.execCommand('copy');
-            showMessage('success', 'Gemini link copied');
-        } catch (e) {
-            showMessage('error', 'Copy failed. Please copy manually');
-        }
-
-        document.body.removeChild(temp);
     });
+
+    function refreshUsage() {
+        postJson('<?= base_url('setting/admin/ai-settings/usage') ?>', {}, function(data) {
+            var usage = data && data.usage ? data.usage : null;
+            if (!usage) {
+                $('#ai_usage_hint').text((data && data.error_text) ? data.error_text : 'Unable to load usage');
+                return;
+            }
+
+            $('#ai_usage_gemini').text((usage.gemini_today || 0) + ' / ' + (usage.daily_limit || 0));
+            $('#ai_usage_fallback').text(usage.fallback_today || 0);
+            $('#ai_usage_total').text(usage.total_today || 0);
+            $('#ai_usage_hour').text(usage.last_hour || 0);
+
+            var level = (usage.level || 'ok').toString();
+            var levelText = 'OK';
+            var levelClass = 'bg-success';
+            if (level === 'warn') {
+                levelText = 'Warning';
+                levelClass = 'bg-warning text-dark';
+            } else if (level === 'danger') {
+                levelText = 'High';
+                levelClass = 'bg-danger';
+            } else if (level === 'critical') {
+                levelText = 'Exceeded';
+                levelClass = 'bg-dark';
+            }
+
+            $('#ai_usage_level').removeClass().addClass('badge ' + levelClass).text(levelText);
+            $('#ai_usage_hint').text('Gemini utilization: ' + (usage.ratio || 0) + '%. Thresholds: 70% warning, 90% high.');
+        });
+    }
+
+    $('#btn_refresh_ai_usage').on('click', function() {
+        refreshUsage();
+    });
+
+    refreshUsage();
 })();
 </script>

app/Views/diagnosis/imaging_ai_result_modal.php

@@ -9,6 +9,23 @@ $provider = trim((string) ($provider ?? 'azure-openai'));
 $model = trim((string) ($model ?? ''));
 $findingsInputId = 'ai_findings_' . $batchId;
 $impressionInputId = 'ai_impression_' . $batchId;
+$providerKey = strtolower($provider);
+$providerLabel = $provider !== '' ? $provider : 'ai-server';
+$providerBadgeClass = 'bg-secondary';
+if ($providerKey === 'gemini') {
+    $providerLabel = 'Gemini';
+    $providerBadgeClass = 'bg-primary';
+} elseif ($providerKey === 'local-xray-fallback') {
+    $providerLabel = 'Local X-ray Fallback';
+    $providerBadgeClass = 'bg-warning text-dark';
+} elseif ($providerKey === 'regex-fallback') {
+    $providerLabel = 'Regex Fallback';
+    $providerBadgeClass = 'bg-warning text-dark';
+} elseif ($providerKey === 'azure-openai') {
+    $providerLabel = 'Azure OpenAI';
+    $providerBadgeClass = 'bg-info text-dark';
+}
+$isFallback = in_array($providerKey, ['local-xray-fallback', 'regex-fallback'], true);
 ?>
 
 <div class="d-flex justify-content-between align-items-start gap-3 flex-wrap mb-3">
@@ -17,7 +34,13 @@ $impressionInputId = 'ai_impression_' . $batchId;
         <?php if ($studyName !== ''): ?>
             <div class="small text-muted">Study: <?= esc($studyName) ?></div>
         <?php endif; ?>
-        <div class="small text-muted">Stored batch #<?= esc((string) $batchId) ?> | <?= esc($provider) ?><?= $model !== '' ? ' / ' . esc($model) : '' ?></div>
+        <div class="small text-muted d-flex align-items-center gap-2 flex-wrap">
+            <span>Stored batch #<?= esc((string) $batchId) ?></span>
+            <span class="badge <?= esc($providerBadgeClass) ?>"><?= esc($providerLabel) ?></span>
+            <?php if ($model !== ''): ?>
+                <span class="badge bg-light text-dark border"><?= esc($model) ?></span>
+            <?php endif; ?>
+        </div>
     </div>
     <div class="d-flex gap-2">
         <button
@@ -43,6 +66,12 @@ $impressionInputId = 'ai_impression_' . $batchId;
     <div class="alert alert-info py-2"><?= esc($summaryText) ?></div>
 <?php endif; ?>
 
+<?php if ($isFallback): ?>
+    <div class="alert alert-warning py-2">
+        Fallback mode used for this draft. Review carefully before sign-off.
+    </div>
+<?php endif; ?>
+
 <div class="row g-3">
     <div class="col-lg-7">
         <div class="card h-100">

app/Views/diagnosis/imaging_upload_gallery.php

@@ -6,7 +6,7 @@ $studyName = trim((string) ($study_name ?? ''));
 <div class="mb-3">
     <div class="d-flex justify-content-between align-items-center gap-2 flex-wrap">
         <div>
-            <h6 class="mb-1">Uploaded Images</h6>
+            <h6 class="mb-1">Uploaded Imaging Files</h6>
             <?php if ($studyName !== ''): ?>
                 <div class="small text-muted">Study: <?= esc($studyName) ?></div>
             <?php endif; ?>
@@ -16,7 +16,7 @@ $studyName = trim((string) ($study_name ?? ''));
 </div>
 
 <?php if ($fileRows === []): ?>
-    <div class="alert alert-warning mb-0">No uploaded images or PDFs found for this study.</div>
+    <div class="alert alert-warning mb-0">No uploaded imaging files found for this study.</div>
 <?php else: ?>
     <div class="row g-3">
         <?php foreach ($fileRows as $row): ?>
@@ -41,11 +41,26 @@ $studyName = trim((string) ($study_name ?? ''));
                             <a href="<?= esc((string) $row['url']) ?>" target="_blank" rel="noopener">
                                 <img src="<?= esc((string) $row['url']) ?>" alt="Uploaded image" class="img-fluid rounded border" style="width:100%; max-height:220px; object-fit:cover;">
                             </a>
+                        <?php elseif (!empty($row['is_dicom']) && !empty($row['dicom_preview_url'])): ?>
+                            <div class="border rounded p-2 bg-light">
+                                <img src="<?= esc((string) $row['dicom_preview_url']) ?>" alt="DICOM preview" class="img-fluid rounded border" style="width:100%; max-height:220px; object-fit:cover;">
+                                <div class="d-flex justify-content-between align-items-center mt-2">
+                                    <span class="badge bg-primary-subtle text-primary-emphasis border">DICOM Preview</span>
+                                    <?php if (!empty($row['url'])): ?>
+                                        <a href="<?= esc((string) $row['url']) ?>" target="_blank" rel="noopener">Open DICOM</a>
+                                    <?php endif; ?>
+                                </div>
+                            </div>
                         <?php elseif (!empty($row['url']) && !empty($row['is_pdf'])): ?>
                             <div class="border rounded p-3 text-center bg-light">
                                 <div class="display-6 text-danger"><i class="bi bi-file-earmark-pdf"></i></div>
                                 <a href="<?= esc((string) $row['url']) ?>" target="_blank" rel="noopener">Open PDF</a>
                             </div>
+                        <?php elseif (!empty($row['url'])): ?>
+                            <div class="border rounded p-3 text-center bg-light">
+                                <div class="display-6 text-primary"><i class="bi bi-file-earmark-medical"></i></div>
+                                <a href="<?= esc((string) $row['url']) ?>" target="_blank" rel="noopener">Open File</a>
+                            </div>
                         <?php else: ?>
                             <div class="border rounded p-3 text-muted bg-light">Preview unavailable</div>
                         <?php endif; ?>

app/Views/diagnosis/pathology_detail.php

@@ -537,6 +537,9 @@ function initializeReportEditor() {
         return;
     }
 
+    // Re-enable notification plugins (may be disabled globally in welcome_message.php)
+    CKEDITOR.config.removePlugins = '';
+
     if (CKEDITOR.instances.HTMLShow) {
         CKEDITOR.instances.HTMLShow.destroy(true);
     }
@@ -902,7 +905,7 @@ function diagnosisUploadForReq(reqId, testName, mode) {
 
     const input = document.createElement('input');
     input.type = 'file';
-    input.accept = 'image/*,application/pdf';
+    input.accept = 'image/*,application/pdf,.dcm,application/dicom,application/dicom+json';
     if ((mode || '').toLowerCase() === 'camera') {
         input.accept = 'image/*';
         input.setAttribute('capture', 'environment');
@@ -976,6 +979,8 @@ function getEditorImagingContext() {
     };
 }
 
+window._imagingSupportModalInstance = window._imagingSupportModalInstance || null;
+
 function openImagingSupportModal(title, html) {
     const titleEl = document.getElementById('imagingSupportLabel');
     const bodyEl = document.getElementById('imagingSupportBody');
@@ -986,8 +991,11 @@ function openImagingSupportModal(title, html) {
         bodyEl.innerHTML = html || '<div class="alert alert-warning mb-0">No content found.</div>';
     }
 
-    const modal = new bootstrap.Modal(document.getElementById('imagingSupportModal'));
+    const el = document.getElementById('imagingSupportModal');
-    modal.show();
+    if (el) {
+        window._imagingSupportModalInstance = bootstrap.Modal.getOrCreateInstance(el);
+        window._imagingSupportModalInstance.show();
+    }
 }
 
 function showImagingUploads(reqId, testName) {
@@ -1094,9 +1102,8 @@ function applyAiDiagnosisDraftToEditor(button, autoSave) {
     }
 
     const modalEl = document.getElementById('imagingSupportModal');
-    const modal = modalEl ? bootstrap.Modal.getInstance(modalEl) : null;
+    if (window._imagingSupportModalInstance) {
-    if (modal) {
+        window._imagingSupportModalInstance.hide();
-        modal.hide();
     }
 
     if (autoSave === true) {