{
  "ptid_time": "137_S_4466_2016-03-08",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4466/2016-03-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 58,525 mm³, 24.5% above the reference mean. With a Z-score of 0.71 (76.1th percentile), this represents normal volume ; hippocampal volume measures 6,449 mm³, 7.5% below the reference mean. With a Z-score of -0.64 (26.0th percentile), this represents normal volume ; whole brain volume measures 1,034,190 mm³, 0.5% above the reference mean. With a Z-score of 0.06 (52.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,909 mm³, 26.7% below the reference mean. With a Z-score of -1.75 (4.0th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,232 mm³, 10.2% below the reference mean. With a Z-score of -0.88 (19.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,990 mm³, 0.9% below the reference mean. With a Z-score of -0.08 (46.8th percentile), this represents normal volume . ",
  "text_data": "Age is 83.8 years. Gender is Male. Education: 16 years. MMSE: 29.0. MoCA: 22.0. Logical Memory: 7.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.98 SUVR (normal ); Amyloid beta: 470.50 pg/mL (mild reduced); Total tau: 207.10 pg/mL (normal ); Phosphorylated tau: 16.97 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.75, 4th percentile), which is a strong early marker of Alzheimer’s pathology, while hippocampal volume is only slightly reduced (Z-score -0.64, normal range). Cognitive scores show a discrepancy—MMSE is normal (29/30), but MoCA (22/30) suggests mild cognitive impairment (MCI). Biomarkers indicate mildly reduced Aβ but normal tau and AV45, which may suggest early amyloid deposition without significant neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting MMSE/MoCA scores and only one strongly atrophic region, but entorhinal cortex atrophy and MoCA support MCI)",
  "timestamp": "2025-07-26T16:32:41.756244"
}