# Metroticket 2.0 AFP-adjusted HCC transplant criteria Metroticket 2.0 Status: LIVE Price: $0.005 USDC `GET /api/calc/metroticket_2` HTML: https://magentlab.com/docs/metroticket-2 Markdown: https://magentlab.com/docs/metroticket-2.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Apply Mazzaferro 2018 Metroticket 2.0 AFP-adjusted-to-HCC-size criteria and return whether a published 70% 5-year HCC-specific survival band holds (meets_70pct_hcc_specific_survival). ## When to use When an agent already has tumor count, largest diameter in centimetres, and serum AFP in ng/mL as in Mazzaferro 2018, and needs the published 70% HCC-specific survival eligibility result. magent does not interpret imaging or assay AFP. ## When not to use - Not a medical device. - Not a transplant listing or organ-allocation order. - magent does not interpret imaging or assay AFP. tumor_count, largest_cm, and afp_ng_ml are caller-assigned. - This tool is Mazzaferro 2018 AFP-adjusted-to-HCC-size 70% 5-year HCC-specific survival criteria only. Not Milan criteria, not UCSF criteria, and not Metroticket 1.0 contours. - Not the online competing-risk survival percentages at hcc-olt-metroticket.org. ## Formula ``` meets_70pct_hcc_specific_survival iff (afp_ng_ml < 200 and size_number_sum <= 7) or (200 <= afp_ng_ml < 400 and size_number_sum <= 5) or (400 <= afp_ng_ml <= 1000 and size_number_sum <= 4); size_number_sum = tumor_count + largest_cm; afp_ng_ml > 1000 is always false (Mazzaferro 2018 AFP-adjusted-to-HCC-size 70% 5-year HCC-specific survival) ``` ## Citation [Metroticket 2.0 Model for Analysis of Competing Risks of Death After Liver Transplantation for Hepatocellular Carcinoma](https://doi.org/10.1053/j.gastro.2017.09.025) Mazzaferro V, Sposito C, Zhou J, Pinna AD, De Carlis L, Fan J, Cescon M, Di Sandro S, Yi-feng H, Lauterio A, Bongini M, Mariani L Gastroenterology. 2018;154(1):128-139 DOI: [10.1053/j.gastro.2017.09.025](https://doi.org/10.1053/j.gastro.2017.09.025) ## Worked example ### Single 3 cm tumor, AFP 50 ng/mL Given: `afp_ng_ml=50, largest_cm=3, tumor_count=1` 1. tumor_count 1 plus largest_cm 3.0 is size_number_sum 4 2. afp_ng_ml 50 is < 200 and size_number_sum 4 is <= 7 3. meets_70pct_hcc_specific_survival is true ## Also searched as - Metroticket 2.0 - Mazzaferro 2018 - AFP-adjusted HCC criteria - HCC transplant AFP size - AFP-adjusted to HCC size - 70 percent HCC-specific survival - hepatocellular carcinoma transplant AFP - liver transplant HCC AFP ## Parameters - `tumor_count` (integer, required): Number of HCC nodules (integer 1-20) as assigned by the caller. Added to largest_cm as size_number_sum (up-to-7 convention). magent does not interpret imaging. - `largest_cm` (number, required): Largest tumor diameter in centimetres (0.1-30) as assigned by the caller. Added to tumor_count as size_number_sum. magent does not interpret imaging. - `afp_ng_ml` (number, required): Serum AFP in ng/mL (1-100000) as assigned by the caller. Mazzaferro 2018 bands: <200 (sum <=7), 200 to <400 (sum <=5), 400 to 1000 (sum <=4); >1000 never meets. magent does not assay AFP. ## 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/metroticket_2` 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": [ { "afp_ng_ml": "50", "largest_cm": "3", "tumor_count": "1" }, { "afp_ng_ml": "50", "largest_cm": "3", "tumor_count": "1" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/metroticket-2 Example 200: ```json { "count": 2, "path": "/api/calc/metroticket_2", "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": "Mazzaferro V, Sposito C, Zhou J, Pinna AD, De Carlis L, Fan J, Cescon M, Di Sandro S, Yi-feng H, Lauterio A, Bongini M, Mariani L", "doi": "10.1053/j.gastro.2017.09.025", "id": "mazzaferro-2018", "pmid": "28989060", "source": "Gastroenterology. 2018;154(1):128-139", "title": "Metroticket 2.0 Model for Analysis of Competing Risks of Death After Liver Transplantation for Hepatocellular Carcinoma" }, "formula": "metroticket_2", "formula_expression": "meets_70pct_hcc_specific_survival iff (afp_ng_ml < 200 and size_number_sum <= 7) or (200 <= afp_ng_ml < 400 and size_number_sum <= 5) or (400 <= afp_ng_ml <= 1000 and size_number_sum <= 4); size_number_sum = tumor_count + largest_cm; afp_ng_ml > 1000 is always false (Mazzaferro 2018 AFP-adjusted-to-HCC-size 70% 5-year HCC-specific survival)", "criteria": [ { "factor": "afp_lt_200_sum_le_7", "met": true }, { "factor": "afp_200_400_sum_le_5", "met": false }, { "factor": "afp_400_1000_sum_le_4", "met": false } ], "largest_cm": 3.0, "tumor_count": 1, "afp_ng_ml": 50.0, "meets_70pct_hcc_specific_survival": true, "size_number_sum": 4.0 }, { "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": "Mazzaferro V, Sposito C, Zhou J, Pinna AD, De Carlis L, Fan J, Cescon M, Di Sandro S, Yi-feng H, Lauterio A, Bongini M, Mariani L", "doi": "10.1053/j.gastro.2017.09.025", "id": "mazzaferro-2018", "pmid": "28989060", "source": "Gastroenterology. 2018;154(1):128-139", "title": "Metroticket 2.0 Model for Analysis of Competing Risks of Death After Liver Transplantation for Hepatocellular Carcinoma" }, "formula": "metroticket_2", "formula_expression": "meets_70pct_hcc_specific_survival iff (afp_ng_ml < 200 and size_number_sum <= 7) or (200 <= afp_ng_ml < 400 and size_number_sum <= 5) or (400 <= afp_ng_ml <= 1000 and size_number_sum <= 4); size_number_sum = tumor_count + largest_cm; afp_ng_ml > 1000 is always false (Mazzaferro 2018 AFP-adjusted-to-HCC-size 70% 5-year HCC-specific survival)", "criteria": [ { "factor": "afp_lt_200_sum_le_7", "met": true }, { "factor": "afp_200_400_sum_le_5", "met": false }, { "factor": "afp_400_1000_sum_le_4", "met": false } ], "largest_cm": 3.0, "tumor_count": 1, "afp_ng_ml": 50.0, "meets_70pct_hcc_specific_survival": true, "size_number_sum": 4.0 } ] } ``` ## Response fields - `formula` (string): metroticket_2 - `formula_expression` (string): Mazzaferro 2018 AFP-adjusted-to-HCC-size 70% 5-year HCC-specific survival: AFP <200 and sum <=7, or 200<=AFP<400 and sum <=5, or 400<=AFP<=1000 and sum <=4 - `meets_70pct_hcc_specific_survival` (boolean): true only when one published AFP-adjusted size-and-number band holds. Not a transplant listing. - `size_number_sum` (number): tumor_count + largest_cm (nodule count plus largest diameter in cm) - `afp_ng_ml` (number): Echo of the caller-assigned AFP in ng/mL - `tumor_count` (integer): Echo of the caller-assigned nodule count (1-20) - `largest_cm` (number): Echo of the caller-assigned largest diameter in centimetres - `criteria` (array): Per-band Tree rows with factor and met for the three AFP-adjusted size-and-number bands - `citation` (object): Mazzaferro 2018 Gastroenterology 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": "Mazzaferro V, Sposito C, Zhou J, Pinna AD, De Carlis L, Fan J, Cescon M, Di Sandro S, Yi-feng H, Lauterio A, Bongini M, Mariani L", "doi": "10.1053/j.gastro.2017.09.025", "id": "mazzaferro-2018", "pmid": "28989060", "source": "Gastroenterology. 2018;154(1):128-139", "title": "Metroticket 2.0 Model for Analysis of Competing Risks of Death After Liver Transplantation for Hepatocellular Carcinoma" }, "formula": "metroticket_2", "formula_expression": "meets_70pct_hcc_specific_survival iff (afp_ng_ml < 200 and size_number_sum <= 7) or (200 <= afp_ng_ml < 400 and size_number_sum <= 5) or (400 <= afp_ng_ml <= 1000 and size_number_sum <= 4); size_number_sum = tumor_count + largest_cm; afp_ng_ml > 1000 is always false (Mazzaferro 2018 AFP-adjusted-to-HCC-size 70% 5-year HCC-specific survival)", "criteria": [ { "factor": "afp_lt_200_sum_le_7", "met": true }, { "factor": "afp_200_400_sum_le_5", "met": false }, { "factor": "afp_400_1000_sum_le_4", "met": false } ], "largest_cm": 3.0, "tumor_count": 1, "afp_ng_ml": 50.0, "meets_70pct_hcc_specific_survival": true, "size_number_sum": 4.0 } ``` ## Errors - HTTP 400 `invalid_tumor_count`: tumor_count must be an integer from 1 to 20 (Mazzaferro 1996). Returned before settlement; you are not charged. - HTTP 400 `invalid_largest_cm`: largest_cm must be a number from 0.1 to 30 (Mazzaferro 1996). Returned before settlement; you are not charged. - HTTP 400 `invalid_afp_ng_ml`: afp_ng_ml must be a number from 1 to 100000 (Mazzaferro 2018 AFP ng/mL). 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 - [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). - [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. - [mRECIST](https://magentlab.com/docs/mrecist) — 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. ## 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.