{
  "ptid_time": "036_S_4491_2012-01-31",
  "img_path": "/data/qiuhui/data/adni/images/036_S_4491/2012-01-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,455 mm³, 16.1% below the reference mean. With a Z-score of -0.47 (32.0th percentile), this represents normal volume ; hippocampal volume measures 6,892 mm³, 1.1% below the reference mean. With a Z-score of -0.09 (46.2th percentile), this represents normal volume ; whole brain volume measures 963,135 mm³, 6.4% below the reference mean. With a Z-score of -0.84 (20.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,691 mm³, 7.0% below the reference mean. With a Z-score of -0.46 (32.3th percentile), this represents normal volume ; fusiform gyrus volume measures 18,256 mm³, 1.1% above the reference mean. With a Z-score of 0.09 (53.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,075 mm³, 0.5% below the reference mean. With a Z-score of -0.04 (48.3th percentile), this represents normal volume . ",
  "text_data": "Age is 84.1 years. Gender is Male. Education: 19 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 30.0. MoCA: 23.0. Logical Memory: 21.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.93 SUVR (mild reduced); Amyloid beta: 1292.00 pg/mL (normal ); Total tau: 165.20 pg/mL (normal ); Phosphorylated tau: 14.19 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "Reasoning: The brain volume measurements (ventricular, hippocampal, whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus) are all within normal ranges, with Z-scores close to the mean. The MMSE score of 30 is normal, but the MoCA score of 23 suggests mild cognitive impairment (MCI). Biomarkers (Aβ, T-tau, P-tau) are normal, and AV45 shows only mild reduction, which does not strongly support Alzheimer's pathology.  \n\nDiagnosis: **MCI**  \nConfidence: **Medium** (due to the discrepancy between MMSE and MoCA, and the lack of strong biomarker evidence for neurodegeneration)",
  "timestamp": "2025-07-26T06:13:54.950600"
}