{
  "ptid_time": "006_S_4346_2011-11-10",
  "img_path": "/data/qiuhui/data/adni/images/006_S_4346/2011-11-10/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 55,341 mm³, 43.7% above the reference mean. With a Z-score of 1.05 (85.2th percentile), this represents mild enlargement; hippocampal volume measures 6,021 mm³, 20.3% below the reference mean. With a Z-score of -1.98 (2.4th percentile), this represents moderate atrophy; whole brain volume measures 1,149,750 mm³, 6.5% above the reference mean. With a Z-score of 0.85 (80.1th percentile), this represents normal volume ; entorhinal cortex volume measures 2,449 mm³, 40.3% below the reference mean. With a Z-score of -2.73 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 17,274 mm³, 8.3% below the reference mean. With a Z-score of -0.71 (24.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,693 mm³, 12.4% below the reference mean. With a Z-score of -1.11 (13.2th percentile), this represents mild atrophy. ",
  "text_data": "Age is 71.3 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Smoking. MMSE: 29.0. MoCA: 27.0. Logical Memory: 6.0. Laboratory findings: . APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.27 SUVR (mild elevated); Amyloid beta: 664.50 pg/mL (normal ); Total tau: 288.00 pg/mL (normal ); Phosphorylated tau: 26.35 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the entorhinal cortex and moderate atrophy in the hippocampus, both key regions affected in Alzheimer's disease (AD). However, cognitive scores (MMSE 29, MoCA 27) are within normal limits, and CSF biomarkers (Aβ, T-tau, P-tau) are normal, which is atypical for AD. The mild AV45 (amyloid PET) elevation could suggest early amyloid deposition, but the overall profile does not strongly support active neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—structural atrophy vs. normal cognition and CSF markers)",
  "timestamp": "2025-07-25T21:36:17.211930"
}