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AURORA-ENCEPH/Deep dive/Spec frozen

AURORA-ENCEPH is an open, federated software stack for the multidisciplinary team caring for a patient with encephalocele.

Encephaloceles are herniations of brain through skull defects with vast anatomical heterogeneity. AURORA-ENCEPH pairs a high-resolution anatomical "prism" with a generative surgical forge.

What it is
A software substrate. 2 subsystems on one federated runtime, installed inside the hospital — not a cloud service, not a black box.
What it does
AURORA-ENCEPH pairs a high-resolution anatomical prism with a generative closure forge. Patient-specific implants and grafts, planned against the right atlas, for one of neurosurgery's most heterogeneous anomalies.
Who uses it
The craniofacial · paediatric neuro · 3d-printing labs MDT at pilot partner institutions today. Open to any hospital under MIT at public alpha (Q4 2026).
Why it exists
So a encephalocele case at any hospital benefits from the substrate the top centres already have. Same code, same model cards, same audit story everywhere.
Subsystems
2
all spec-frozen
Pilot sites
1 craniofacial centre · 1 LMIC programme
scoping → live
Working papers
2
drafts in flight
Latency
target <150ms
median per case
License
MIT
@ public alpha
Stage
Beta
public alpha Q4 2026
I · The clinical surface

What clinicians actually see.

A non-functional preview of the AURORA-ENCEPH surface. Composable panels, logged overrides, explainable end-to-end. Pilot sites tune this to their own workflow.

FidelityPixel-accurate mock — no live data.
SubstrateReact 18 · CSS custom properties · no framework lock-in.
ScopeVocabulary for all AURORA-* surfaces.

MRN-455281 · frontoethmoidal · 8mo

beta1 craniofacial centre override · 2
Stage
Prism atlas in alpha
Subsystems
2/2 ready
Latency
target <150ms
Audit log
on
Primary modality · overlayupdated 2s ago
10 mm
σ = 1.4 mm·ROI 24.7 cm³
overlay field
plan draft
Subsystem signalsupdated 2s ago
ENCEPH-PRISM   Anatomical Prism81%
ENCEPH-FORGE   Surgical Forge67%
Aesthetic score (proj.)
+27%
Reoperation risk (proj.)
−42%
II · The clinical case

Why an open module for encephalocele.

AURORA-ENCEPH pairs a high-resolution anatomical prism with a generative closure forge. Patient-specific implants and grafts, planned against the right atlas, for one of neurosurgery's most heterogeneous anomalies.

Encephaloceles are among the most heterogeneous neurosurgical anomalies. Closure is patient-specific, often resource-constrained, and outcomes depend on details no textbook captures. AURORA-ENCEPH builds a high-resolution anatomical atlas and a forge for personalised closures.

Subtype matters: frontoethmoidal, parietal and occipital encephaloceles differ in anatomy, surgical approach, aesthetic expectations and outcome envelopes. ENCEPH-PRISM keeps these atlases distinct rather than averaging them away.

ENCEPH-FORGE turns the planning conversation into a concrete artefact — a printable, sterilisable phantom and a draft implant geometry. The point is not to remove surgeon judgement; the point is to give it something to react to before theatre.

We are not building a product around Encephalocele. We are seeding an infrastructure — so that any hospital with the will to use it can.
ENCEPH · ANATOMICAL PRISM × GENERATIVE FORGE

From defect to graft.

AURORA-ENCEPH pairs a high-resolution anatomical prism with a generative closure forge. Defect topology in; patient-specific implant out; surgeon-reviewed before any print job.

PRE · ENCEPH-PRISMDEFECT · 38 × 22 mmFORGEPOST · ENCEPH-FORGEPATIENT-SPECIFIC GRAFT
ENCEPH-PRISM · sub-millimetre anatomical priors, atlas-aware.
ENCEPH-FORGE · generative implant + graft topology, surgeon-reviewed before print.
Print-shop ready · STL + DICOM-RT bundle, signed and audited.
III · The stack

2 subsystems. Each one independently useful.

Every AURORA-ENCEPH subsystem can be adopted alone or as part of the bundle. Each ships with its own model cards, eval results and a one-command install.

ENCEPH · 01 live

Anatomical Prism

ENCEPH-PRISM

Voxel-precise atlas of frontoethmoidal, parietal and occipital subtypes.

Voxel-precise atlas of frontoethmoidal, parietal and occipital subtypes — preserves the differences instead of averaging.

ENCEPH · 02 beta

Surgical Forge

ENCEPH-FORGE

Generative closure planning with patient-specific implants and grafts.

Generative closure planning. Produces patient-specific implant and graft topologies for review and printing.

IV · The product, in detail

What AURORA-ENCEPH produces, end-to-end.

Inputs the module reads from your existing systems, outputs it returns to them, the protocols it speaks, and the lifecycle of one case as it moves through AURORA-ENCEPH.

01Inputs4 types
Imaging
Modality set defined by the module's RFC.
DICOM 3.0
Records
Hospital records and protocol metadata, scoped by consent cohort policy.
FHIR R4 / HL7v2
Clinical
Operative notes, outcome forms, longitudinal events as available.
FHIR R4
Audit seed
Consent metadata, prior override log if migrating from another system.
AURORA audit (NDJSON)
02Outputs4 artefacts
Integrated assessment
Module-specific structured report combining 2 subsystem signals.
Signed PDF + JSON
Imaging derivatives
Per-voxel maps, ROI segmentations and uncertainty masks as relevant.
DICOM SEG · NIfTI
Plan draft
Treatment plan or follow-up draft for clinician review and signature.
Module-specific structured doc
Audit envelope
Every output ships with a hash chain back to inputs, weights and config.
AURORA audit (NDJSON)
03Case lifecycle6 steps · median target <150ms
  1. 01
    Bind
    Imaging or record arrives at PACS/EHR. AURORA binds the case by SOP/MRN, checks consent policy.
  2. 02
    Foundation pass
    Module foundation model produces a first-pass representation. Median target <150ms on partner-site hardware.
  3. 03
    Subsystem fan-out
    2 subsystems run in parallel; each writes its signal + uncertainty to the case.
  4. 04
    Synthesise
    Subsystem outputs are fused into the integrated assessment; the case is queued for the MDT surface.
  5. 05
    Clinician review
    MDT reviews on the AURORA surface. Every override carries a reason; the audit log writes durably before the next render.
  6. 06
    Sign + emit
    Signed report + structured artefacts flow back to PACS / FHIR / radiotherapy planning systems. Hash chain closes.
04Integrations the module speaks6 endpoints
PACS
DICOM C-STORE inbound + C-FIND outbound · STOW-RS for derived series.
EHR
FHIR R4 — DiagnosticReport, Condition, Observation, ServiceRequest. OAuth2 client credentials.
Lab feeds
HL7v2 (ORU^R01) for legacy molecular and laboratory results.
Auth
OIDC — Microsoft AD FS, Okta, Keycloak. Per-clinician identity in every override log entry.
Provenance
Sigstore-signed weights + container digests. Per-site federation key in Vault or KMS.
Telemetry
Off by default. When enabled, opt-in per-site; payload schema is in the module RFC.
05Per-subsystem, in detail2 units · independently installable
ENCEPH-PRISM
Anatomical Prism
live

Voxel-precise atlas of frontoethmoidal, parietal and occipital subtypes — preserves the differences instead of averaging.

ENCEPH-FORGE
Surgical Forge
beta

Generative closure planning. Produces patient-specific implant and graft topologies for review and printing.

Reversibility
Nothing the module installs is destructive. Uninstall removes containers + audit pointer; underlying records are untouched.
Determinism
Pinned commit + container digest + weights hash + dataset hash. Every AURORA-ENCEPH run is re-runnable and re-attributable.
Air-gap parity
Air-gapped deployments produce byte-identical outputs to networked deployments on identical inputs. No silent telemetry, ever.
Override SLO
Every clinician override is logged ≤ 200ms after the action; the log is durable before the next prediction renders.
V · Working papers

Our own writing on AURORA-ENCEPH.

2 drafts by the module team and pilot collaborators. Each documents one slice of the substrate — methods, evaluation protocol, lessons. Slot PDFs in as they're ready; the entries point to placeholders until then.

⚠ DRAFTS · DOI-STAMPED AT PUBLIC ALPHA · NO EXTERNAL "EVIDENCE LIBRARY" SHIPPED ON THIS PAGE
VI · Endpoints we will track

The metrics that matter over a lifetime.

These are the endpoints AURORA-ENCEPH is built to measure across pilot deployments. The targets below are pilot goals, not retrospective results.

−42%
target
Reoperation rate

On forge-planned closures vs historical baseline (target).

+27%
target
Aesthetic score

Blinded panel rating at 12 months.

8.4h
target
Plan-to-print

From DICOM in to sterilizable phantom out.

+15%
target
Neurodev follow-up rate

Better long-term tracking of cohort.

100%
target
Auditable override rate

Every override logged with reason.

−30%
target
Theatre-time variance

Tighter spread of operative durations.

⚠ PILOT TARGETS · NOT RETROSPECTIVE RESULTS · TO BE VALIDATED AT PUBLIC ALPHA
VII · Install AURORA-ENCEPH

From pip install to a hospital deploy in one afternoon.

Available to pilot partners today on private registries. At public alpha (Q4 2026) the same images, weights and signatures ship under MIT on public registries. For the full per-product download grid, see the unified download page.

step 1 of 3
pip install aurora-enceph
step 2 of 3
aurora doctor enceph
# → AURORA-ENCEPH  ✓ python  ✓ atlas  ✓ forge
step 3 of 3
from aurora.enceph import plan
artefact = plan(case_id="bench/enceph/case-0002")
artefact.export_stl("phantom.stl")
Hardware
CPU · NVIDIA · AMD · Apple silicon
OS
Linux · macOS · Windows · WSL
Deploys
Cloud · On-prem · Air-gapped · Edge
Telemetry
Opt-in · Off by default

Hardware footprint, in practice

AURORA-ENCEPH is designed to run on hardware that already exists inside hospital networks. CPU-only inference is supported for the lighter subsystems; the heavier ones benefit from a recent GPU but do not require one. A single modern workstation handles routine cases under the latency target.

Networking and consent

Federated deploys do not require open inbound ports. The runtime opens an outbound mTLS connection to the federation control plane; model updates are signed, audited and pulled. Patient data never traverses the federation. Consent metadata is a first-class object — subsystems with an explicit consent dependency refuse to run on records that lack the appropriate cohort policy.

Migration paths

Most pilot sites land on AURORA-ENCEPH with an existing system in place. The recommended path is: install alongside, compare outputs on a held-out cohort for one quarter, then move read-only surfaces to AURORA, and decide on the rest. Reversibility is a design goal — nothing in the install creates lock-in.

Download grid

For the full per-product, per-platform download buttons (macOS / Windows / Linux installers + pip / docker / helm / rust commands), see the unified download page. Each subsystem of AURORA-ENCEPH is independently downloadable there.

VIII · Questions

The honest questions on AURORA-ENCEPH.

Eight diseases is the beginning.

AURORA is in private pilot today and opens to the world at public alpha in Q4 2026 under MIT. If you carry the weight of these diseases — as a clinician, scientist, builder, patient or advocate — there is a seat at the table.

Changelogv0.6.0