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Fleischner 2017 incidental solid nodule

Fleischner 2017

Apply the MacMahon 2017 Fleischner Society table for a single solid noncalcified incidental pulmonary nodule and return the published follow-up recommendation from average diameter and caller-assigned high versus low clinical risk.

LIVE $0.005 USDC GET /api/calc/fleischner_2017

Markdown: /docs/fleischner-2017.md · Canonical: https://magentlab.com/docs/fleischner-2017

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Apply the MacMahon 2017 Fleischner Society table for a single solid noncalcified incidental pulmonary nodule and return the published follow-up recommendation from average diameter and caller-assigned high versus low clinical risk.

When to use

When an agent already has average diameter in millimetres for one solid incidental nodule and a caller-assigned high_risk flag, and needs the 2017 Fleischner solid-solitary row. magent does not read CT. Not Lung-RADS screening. Not subsolid or multiple nodules.

When not to use

• Not a medical device and not a diagnosis. Not an imaging or biopsy order.
• MacMahon 2017 table for incidental solid solitary noncalcified nodules only. Not subsolid (ground-glass or part-solid) and not multiple nodules.
• Not lung-cancer screening and not Lung-RADS. magent does not measure the nodule or read CT; size_mm is caller-supplied average diameter.
• high_risk is assigned by the caller (for example heavy smoking or other published high-risk features). magent does not compute a risk model.
• Size 1-30 mm is an implementation clamp for a nodule (not a mass). The 2017 guidelines address adults 35 years or older; magent does not take age.

Formula

Single solid noncalcified incidental nodule (MacMahon 2017): size_mm < 6 → no_routine_followup if not high_risk else optional_ct_12_months; 6 <= size_mm <= 8 → ct_6_12_then_consider_18_24 if not high_risk else ct_6_12_then_18_24; size_mm > 8 → consider_ct_3_pet_or_tissue (low or high risk). Not subsolid. Not multiple nodules. Not Lung-RADS screening. magent does not read CT.

Citation

Title

Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017

Authors

MacMahon H, Naidich DP, Goo JM, Lee KS, Leung ANC, Rajendran K, Travis WD, Bankier AA

Source

Radiology. 2017;284(1):228-243

DOI

10.1148/radiol.2017161659

Worked example

Also searched as

• Fleischner 2017
• Fleischner Society nodule guidelines
• incidental pulmonary nodule CT
• MacMahon 2017 Fleischner
• solid nodule follow-up
• Fleischner solid nodule table
• incidental solid pulmonary nodule

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/fleischner_2017?size_mm=5&high_risk=false

Full URL: https://api.magentlab.com/api/calc/fleischner_2017?size_mm=5&high_risk=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/fleischner_2017?size_mm=5&high_risk=false"

Parameters

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/fleischner_2017 Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

• 1 to 25 items. Each item uses the same keys as the GET query parameters.
• POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
• The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
• HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
• Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
• x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "high_risk": "false",
      "size_mm": "5"
    },
    {
      "high_risk": "false",
      "size_mm": "5"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/fleischner_2017",
  "items": [
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "MacMahon H, Naidich DP, Goo JM, Lee KS, Leung ANC, Rajendran K, Travis WD, Bankier AA",
        "doi": "10.1148/radiol.2017161659",
        "id": "macmahon-2017",
        "pmid": "28240562",
        "source": "Radiology. 2017;284(1):228-243",
        "title": "Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017"
      },
      "formula": "fleischner_2017",
      "formula_expression": "Single solid noncalcified incidental nodule (MacMahon 2017): size_mm < 6 → no_routine_followup if not high_risk else optional_ct_12_months; 6 <= size_mm <= 8 → ct_6_12_then_consider_18_24 if not high_risk else ct_6_12_then_18_24; size_mm > 8 → consider_ct_3_pet_or_tissue (low or high risk). Not subsolid. Not multiple nodules. Not Lung-RADS screening. magent does not read CT.",
      "high_risk": false,
      "criteria": [
        {
          "value": 5.0,
          "factor": "size_lt_6",
          "met": true
        },
        {
          "value": 5.0,
          "factor": "size_6_to_8",
          "met": false
        },
        {
          "value": 5.0,
          "factor": "size_gt_8",
          "met": false
        },
        {
          "factor": "high_risk",
          "met": false
        }
      ],
      "recommendation": "no_routine_followup",
      "size_band": "<6"
    },
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "MacMahon H, Naidich DP, Goo JM, Lee KS, Leung ANC, Rajendran K, Travis WD, Bankier AA",
        "doi": "10.1148/radiol.2017161659",
        "id": "macmahon-2017",
        "pmid": "28240562",
        "source": "Radiology. 2017;284(1):228-243",
        "title": "Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017"
      },
      "formula": "fleischner_2017",
      "formula_expression": "Single solid noncalcified incidental nodule (MacMahon 2017): size_mm < 6 → no_routine_followup if not high_risk else optional_ct_12_months; 6 <= size_mm <= 8 → ct_6_12_then_consider_18_24 if not high_risk else ct_6_12_then_18_24; size_mm > 8 → consider_ct_3_pet_or_tissue (low or high risk). Not subsolid. Not multiple nodules. Not Lung-RADS screening. magent does not read CT.",
      "high_risk": false,
      "criteria": [
        {
          "value": 5.0,
          "factor": "size_lt_6",
          "met": true
        },
        {
          "value": 5.0,
          "factor": "size_6_to_8",
          "met": false
        },
        {
          "value": 5.0,
          "factor": "size_gt_8",
          "met": false
        },
        {
          "factor": "high_risk",
          "met": false
        }
      ],
      "recommendation": "no_routine_followup",
      "size_band": "<6"
    }
  ]
}

Response

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "MacMahon H, Naidich DP, Goo JM, Lee KS, Leung ANC, Rajendran K, Travis WD, Bankier AA",
    "doi": "10.1148/radiol.2017161659",
    "id": "macmahon-2017",
    "pmid": "28240562",
    "source": "Radiology. 2017;284(1):228-243",
    "title": "Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017"
  },
  "formula": "fleischner_2017",
  "formula_expression": "Single solid noncalcified incidental nodule (MacMahon 2017): size_mm < 6 → no_routine_followup if not high_risk else optional_ct_12_months; 6 <= size_mm <= 8 → ct_6_12_then_consider_18_24 if not high_risk else ct_6_12_then_18_24; size_mm > 8 → consider_ct_3_pet_or_tissue (low or high risk). Not subsolid. Not multiple nodules. Not Lung-RADS screening. magent does not read CT.",
  "high_risk": false,
  "criteria": [
    {
      "value": 5.0,
      "factor": "size_lt_6",
      "met": true
    },
    {
      "value": 5.0,
      "factor": "size_6_to_8",
      "met": false
    },
    {
      "value": 5.0,
      "factor": "size_gt_8",
      "met": false
    },
    {
      "factor": "high_risk",
      "met": false
    }
  ],
  "recommendation": "no_routine_followup",
  "size_band": "<6"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

Related tools

• Mayo SPN — Compute the Swensen 1997 Mayo Clinic logistic probability of malignancy for a radiologically indeterminate solitary pulmonary nodule from age, smoking, remote extrathoracic cancer, diameter, spiculation, and upper-lobe location.

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

• HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
• exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
• HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
• Execution is timeout-bounded and concurrency-capped.
• Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.