{
  "ptid_time": "002_S_4219_2011-09-14",
  "img_path": "/data/qiuhui/data/adni/images/002_S_4219/2011-09-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,437 mm³, 44.1% above the reference mean. With a Z-score of 1.01 (84.4th percentile), this represents mild enlargement; hippocampal volume measures 6,383 mm³, 10.3% below the reference mean. With a Z-score of -0.94 (17.3th percentile), this represents normal volume ; whole brain volume measures 977,965 mm³, 0.3% above the reference mean. With a Z-score of 0.04 (51.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,787 mm³, 3.1% above the reference mean. With a Z-score of 0.19 (57.6th percentile), this represents normal volume ; fusiform gyrus volume measures 19,019 mm³, 11.8% above the reference mean. With a Z-score of 1.07 (85.8th percentile), this represents mild enlargement; middle temporal gyrus volume measures 18,469 mm³, 3.7% below the reference mean. With a Z-score of -0.32 (37.6th percentile), this represents normal volume . ",
  "text_data": "Age is 79.4 years. Gender is Female. Education: 17 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 30.0. MoCA: 22.0. Logical Memory: 6.0. Laboratory findings: Total Bilirubin: 0.90 (significant elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.06 SUVR (normal ); Amyloid beta: 908.70 pg/mL (normal ); Total tau: 119.10 pg/mL (moderate reduced); Phosphorylated tau: 10.16 pg/mL (moderate reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild ventricular enlargement and a normal hippocampal volume, which are not strongly indicative of Alzheimer's pathology. The MMSE is normal (30/30), but the MoCA (22/30) suggests mild cognitive impairment. Biomarkers (Aβ normal, reduced T-tau and P-tau, normal AV45) do not support Alzheimer’s disease.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (due to conflicting MoCA and biomarker results, but no clear dementia or Alzheimer's evidence)",
  "timestamp": "2025-07-25T20:21:50.933711"
}