{
  "ptid_time": "057_S_2398_2011-07-05",
  "img_path": "/data/qiuhui/data/adni/images/057_S_2398/2011-07-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,093 mm³, 40.4% above the reference mean. With a Z-score of 0.97 (83.4th percentile), this represents normal volume ; hippocampal volume measures 7,207 mm³, 4.7% below the reference mean. With a Z-score of -0.45 (32.5th percentile), this represents normal volume ; whole brain volume measures 1,111,740 mm³, 3.0% above the reference mean. With a Z-score of 0.39 (65.1th percentile), this represents normal volume ; entorhinal cortex volume measures 4,098 mm³, 0.1% below the reference mean. With a Z-score of -0.00 (49.8th percentile), this represents normal volume ; fusiform gyrus volume measures 19,988 mm³, 6.1% above the reference mean. With a Z-score of 0.52 (69.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,579 mm³, 12.9% below the reference mean. With a Z-score of -1.16 (12.2th percentile), this represents mild atrophy. ",
  "text_data": "Age is 71.5 years. Gender is Male. Education: 13 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 29.0. MoCA: 23.0. Logical Memory: 8.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.10 SUVR (normal ); Amyloid beta: 549.70 pg/mL (mild reduced); Total tau: 163.30 pg/mL (normal ); Phosphorylated tau: 12.16 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild atrophy in the middle temporal gyrus but otherwise normal volumes in key regions like the hippocampus and entorhinal cortex. Cognitive testing reveals a high MMSE (29) but a borderline MoCA (23), along with mixed biomarker findings (mildly reduced Aβ and P-tau, normal T-tau and AV45). The presence of two APOE4 alleles increases Alzheimer's risk, but the overall profile does not strongly indicate dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to borderline MoCA and mixed biomarkers, but preserved MMSE and mostly normal brain volumes)",
  "timestamp": "2025-07-26T08:12:55.914961"
}