{
  "ptid_time": "141_S_4053_2011-05-24",
  "img_path": "/data/qiuhui/data/adni/images/141_S_4053/2011-05-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 46,972 mm³, 22.0% above the reference mean. With a Z-score of 0.53 (70.0th percentile), this represents normal volume ; hippocampal volume measures 6,981 mm³, 7.6% below the reference mean. With a Z-score of -0.75 (22.8th percentile), this represents normal volume ; whole brain volume measures 1,069,060 mm³, 1.0% below the reference mean. With a Z-score of -0.12 (45.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,635 mm³, 11.4% below the reference mean. With a Z-score of -0.77 (22.1th percentile), this represents normal volume ; fusiform gyrus volume measures 16,741 mm³, 11.1% below the reference mean. With a Z-score of -0.95 (17.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,940 mm³, 2.8% above the reference mean. With a Z-score of 0.25 (60.0th percentile), this represents normal volume . ",
  "text_data": "Age is 75.3 years. Gender is Male. Education: 17 years. Handedness: Right. Race: White. Medical history: Cardiovascular; Dermatologic-Connective Tissue; Hematopoietic-Lymphatic; Renal-Genitourinary. MMSE: 29.0. MoCA: 21.0. Logical Memory: 3.0. Laboratory findings: Neutrophils: 6.24 (significant elevated). APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.49 SUVR (profound elevated); Amyloid beta: 879.00 pg/mL (normal ); Total tau: 549.70 pg/mL (profound elevated); Phosphorylated tau: 50.45 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows normal brain volumes across all measured regions, with no significant atrophy. However, the MoCA score of 21 suggests mild cognitive impairment, and the biomarker profile (elevated T-tau, P-tau, and AV45 with normal Aβ) is atypical for Alzheimer’s but may indicate another neurodegenerative process.  \n\n**Diagnosis:** MCI (Mild Cognitive Impairment)  \n**Confidence:** Medium (due to conflicting biomarkers and preserved brain volumes despite cognitive decline)",
  "timestamp": "2025-07-26T17:01:25.667693"
}