# mRECIST for HCC mRECIST Status: LIVE Price: $0.005 USDC `GET /api/calc/mrecist` HTML: https://magentlab.com/docs/mrecist Markdown: https://magentlab.com/docs/mrecist.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Apply Lencioni 2010 modified RECIST (mRECIST) for hepatocellular carcinoma and return target-lesion overall response CR, PR, SD, or PD from caller-assigned viable-tumor flags. ## When to use When an agent already has caller-assigned flags for new lesions, disappearance of intratumoral arterial enhancement in all target lesions, a 30% or greater viable-sum reduction versus baseline, and a 20% or greater viable-sum increase versus nadir, and needs the published first-match mRECIST category. magent does not measure arterial-phase enhancement or read CT/MRI. ## When not to use - Not a medical device. - Not a diagnosis. Response category is not an HCC diagnosis or a treatment recommendation. - HCC target-lesion mRECIST only (Lencioni 2010 typical intrahepatic target lesions). - Not RECIST 1.1. Unidimensional viable (arterial-enhancing) tumor is scored; conventional RECIST 1.1 longest-diameter rules are out of scope. - magent does not read imaging or measure arterial-phase enhancement. All flags are caller-assigned. - Not nontarget-only overall response. This tool does not combine a separate nontarget-lesion category with target-lesion response. - Not EASL necrosis-only criteria. - Does not apply the 2019 Llovet J Hepatol 5 mm absolute increase as an extra PD requirement (a later RECIST-style refinement). viable_sum_increase_ge_20 is the 20% or greater viable-sum increase versus nadir as assigned by the caller. ## Formula ``` mrecist first-match: PD if new_lesion or viable_sum_increase_ge_20; else CR if enhancement_disappeared; else PR if viable_sum_reduction_ge_30; else SD (Lencioni 2010 typical intrahepatic target lesions). Not RECIST 1.1. Not EASL necrosis-only. Not the 2019 Llovet +5 mm PD refinement. magent does not read imaging. Not a diagnosis ``` ## Citation [Modified RECIST (mRECIST) assessment for hepatocellular carcinoma](https://doi.org/10.1055/s-0030-1247132) Lencioni R, Llovet JM Semin Liver Dis. 2010;30(1):52-60 DOI: [10.1055/s-0030-1247132](https://doi.org/10.1055/s-0030-1247132) ## Worked example ### Complete response: arterial enhancement disappeared Given: `enhancement_disappeared=true, new_lesion=false, viable_sum_increase_ge_20=false, viable_sum_reduction_ge_30=false` 1. new_lesion false and viable_sum_increase_ge_20 false, so not PD 2. enhancement_disappeared true (no remaining intratumoral arterial enhancement in all target lesions) 3. mrecist is CR ## Also searched as - mRECIST - modified RECIST HCC - Lencioni 2010 mRECIST - HCC arterial enhancement response - viable tumor RECIST - modified RECIST hepatocellular carcinoma - mRECIST CR PR SD PD - HCC target lesion response ## Parameters - `new_lesion` (boolean, required): One or more new lesions as assigned by the caller (Lencioni 2010 mRECIST PD). true or false. When true, mrecist is PD regardless of enhancement or viable-sum flags. magent does not read imaging. - `viable_sum_increase_ge_20` (boolean, required): ≥20% increase in the sum of diameters of viable (arterial-enhancing) target lesions versus nadir, as assigned by the caller (Lencioni 2010 mRECIST PD). Do not also require a 5 mm absolute increase. true or false. magent does not measure lesions. - `enhancement_disappeared` (boolean, required): Disappearance of any intratumoral arterial enhancement in all target lesions, as assigned by the caller (Lencioni 2010 mRECIST CR). true or false. magent does not measure arterial-phase enhancement or read CT/MRI. - `viable_sum_reduction_ge_30` (boolean, required): ≥30% decrease in the sum of diameters of viable (arterial-enhancing) target lesions versus baseline, as assigned by the caller (Lencioni 2010 mRECIST PR). true or false. magent does not measure lesions. ## 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. Method: `POST /api/calc/mrecist` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: 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: ```json { "items": [ { "enhancement_disappeared": "true", "new_lesion": "false", "viable_sum_increase_ge_20": "false", "viable_sum_reduction_ge_30": "false" }, { "enhancement_disappeared": "true", "new_lesion": "false", "viable_sum_increase_ge_20": "false", "viable_sum_reduction_ge_30": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/mrecist Example 200: ```json { "count": 2, "path": "/api/calc/mrecist", "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": "Lencioni R, Llovet JM", "doi": "10.1055/s-0030-1247132", "id": "lencioni-2010", "pmid": "20175033", "source": "Semin Liver Dis. 2010;30(1):52-60", "title": "Modified RECIST (mRECIST) assessment for hepatocellular carcinoma" }, "formula": "mrecist", "formula_expression": "mrecist first-match: PD if new_lesion or viable_sum_increase_ge_20; else CR if enhancement_disappeared; else PR if viable_sum_reduction_ge_30; else SD (Lencioni 2010 typical intrahepatic target lesions). Not RECIST 1.1. Not EASL necrosis-only. Not the 2019 Llovet +5 mm PD refinement. magent does not read imaging. Not a diagnosis", "criteria": [ { "factor": "new_lesion", "met": false }, { "factor": "viable_sum_increase_ge_20", "met": false }, { "factor": "enhancement_disappeared", "met": true }, { "factor": "viable_sum_reduction_ge_30", "met": false } ], "mrecist": "CR" }, { "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": "Lencioni R, Llovet JM", "doi": "10.1055/s-0030-1247132", "id": "lencioni-2010", "pmid": "20175033", "source": "Semin Liver Dis. 2010;30(1):52-60", "title": "Modified RECIST (mRECIST) assessment for hepatocellular carcinoma" }, "formula": "mrecist", "formula_expression": "mrecist first-match: PD if new_lesion or viable_sum_increase_ge_20; else CR if enhancement_disappeared; else PR if viable_sum_reduction_ge_30; else SD (Lencioni 2010 typical intrahepatic target lesions). Not RECIST 1.1. Not EASL necrosis-only. Not the 2019 Llovet +5 mm PD refinement. magent does not read imaging. Not a diagnosis", "criteria": [ { "factor": "new_lesion", "met": false }, { "factor": "viable_sum_increase_ge_20", "met": false }, { "factor": "enhancement_disappeared", "met": true }, { "factor": "viable_sum_reduction_ge_30", "met": false } ], "mrecist": "CR" } ] } ``` ## Response fields - `formula` (string): mrecist - `formula_expression` (string): Lencioni 2010 mRECIST first-match target-lesion overall response (PD, CR, PR, or SD) - `mrecist` (string): CR, PR, SD, or PD. First-match on caller-assigned typical intrahepatic target-lesion flags. Not a diagnosis. Not RECIST 1.1. - `criteria` (array): Per-factor Tree rows with factor and met for new_lesion, viable_sum_increase_ge_20, enhancement_disappeared, and viable_sum_reduction_ge_30 - `citation` (object): Lencioni 2010 Semin Liver Dis mRECIST citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "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": "Lencioni R, Llovet JM", "doi": "10.1055/s-0030-1247132", "id": "lencioni-2010", "pmid": "20175033", "source": "Semin Liver Dis. 2010;30(1):52-60", "title": "Modified RECIST (mRECIST) assessment for hepatocellular carcinoma" }, "formula": "mrecist", "formula_expression": "mrecist first-match: PD if new_lesion or viable_sum_increase_ge_20; else CR if enhancement_disappeared; else PR if viable_sum_reduction_ge_30; else SD (Lencioni 2010 typical intrahepatic target lesions). Not RECIST 1.1. Not EASL necrosis-only. Not the 2019 Llovet +5 mm PD refinement. magent does not read imaging. Not a diagnosis", "criteria": [ { "factor": "new_lesion", "met": false }, { "factor": "viable_sum_increase_ge_20", "met": false }, { "factor": "enhancement_disappeared", "met": true }, { "factor": "viable_sum_reduction_ge_30", "met": false } ], "mrecist": "CR" } ``` ## Errors - HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [BCLC](https://magentlab.com/docs/bclc) — Apply Reig 2022 BCLC staging and return bclc_stage (0, A, B, C, or D) with the published expected median survival. Stage only. Not a treatment recommendation. - [Milan](https://magentlab.com/docs/milan) — Apply Mazzaferro 1996 Milan criteria and return whether the published size, count, vascular-invasion, and extrahepatic rules all hold (meets_milan). ## 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. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/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.