{
  "ptid_time": "032_S_4921_2012-09-06",
  "img_path": "/data/qiuhui/data/adni/images/032_S_4921/2012-09-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,026 mm³, 46.6% above the reference mean. With a Z-score of 1.11 (86.6th percentile), this represents mild enlargement; hippocampal volume measures 7,475 mm³, 6.9% below the reference mean. With a Z-score of -0.69 (24.6th percentile), this represents normal volume ; whole brain volume measures 1,180,230 mm³, 4.0% above the reference mean. With a Z-score of 0.57 (71.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,579 mm³, 16.0% below the reference mean. With a Z-score of -1.11 (13.3th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,763 mm³, 15.8% below the reference mean. With a Z-score of -1.31 (9.4th percentile), this represents mild atrophy; middle temporal gyrus volume measures 22,453 mm³, 0.2% above the reference mean. With a Z-score of 0.02 (50.6th percentile), this represents normal volume . ",
  "text_data": "Age is 66.7 years. Gender is Male. Education: 20 years. Handedness: Right. Race: Black or African American. Medical history: Cardiovascular; Hematopoietic-Lymphatic; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 30.0. MoCA: 26.0. Logical Memory: 13.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.11 SUVR (normal ); Amyloid beta: 1291.00 pg/mL (normal ); Total tau: 130.30 pg/mL (mild reduced); Phosphorylated tau: 11.77 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging shows mild ventricular enlargement and mild atrophy in the entorhinal cortex and fusiform gyrus, regions often affected in early Alzheimer's. However, hippocampal volume is normal, and biomarkers (Aβ, tau, AV45) do not strongly support Alzheimer's pathology. Cognitive scores (MMSE 30, MoCA 26) suggest very mild impairment, possibly MCI.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (Structural changes suggest early neurodegeneration, but biomarker and cognitive profiles are not definitive for dementia.)",
  "timestamp": "2025-07-26T05:06:47.682671"
}