{
  "ptid_time": "141_S_4803_2012-06-23",
  "img_path": "/data/qiuhui/data/adni/images/141_S_4803/2012-06-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,574 mm³, 44.3% below the reference mean. With a Z-score of -1.20 (11.6th percentile), this represents mild atrophy; hippocampal volume measures 6,110 mm³, 5.9% below the reference mean. With a Z-score of -0.48 (31.7th percentile), this represents normal volume ; whole brain volume measures 897,970 mm³, 3.3% below the reference mean. With a Z-score of -0.39 (34.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,243 mm³, 6.3% below the reference mean. With a Z-score of -0.34 (36.6th percentile), this represents normal volume ; fusiform gyrus volume measures 14,226 mm³, 11.7% below the reference mean. With a Z-score of -0.88 (19.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,003 mm³, 0.1% below the reference mean. With a Z-score of -0.01 (49.5th percentile), this represents normal volume . ",
  "text_data": "Age is 82.7 years. Gender is Female. Education: 14 years. MMSE: 29.0. MoCA: 20.0. Logical Memory: 5.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.34 SUVR (significant elevated); Amyloid beta: 1252.00 pg/mL (normal ); Total tau: 827.80 pg/mL (profound elevated); Phosphorylated tau: 91.28 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The brain volume measurements show mild ventricular atrophy but otherwise normal volumes in key regions like the hippocampus, entorhinal cortex, and temporal structures. However, the MoCA score of 20 suggests cognitive impairment, and the biomarker profile (normal Aβ but elevated T-tau, P-tau, and AV45) is atypical for Alzheimer's but may indicate another neurodegenerative process.  \nDiagnosis: MCI  \nConfidence: Medium  \n\n(Note: The discordance between normal Aβ and elevated tau/AV45 makes Alzheimer's less likely, but the MoCA score and mild atrophy suggest cognitive decline. Further clinical correlation is needed to determine the underlying pathology",
  "timestamp": "2025-07-26T17:05:29.742983"
}