{
  "ptid_time": "027_S_0118_2011-02-03",
  "img_path": "/data/qiuhui/data/adni/images/027_S_0118/2011-02-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 47,469 mm³, 1.0% above the reference mean. With a Z-score of 0.03 (51.1th percentile), this represents normal volume ; hippocampal volume measures 4,888 mm³, 29.9% below the reference mean. With a Z-score of -2.58 (0.5th percentile), this represents significant atrophy; whole brain volume measures 903,521 mm³, 12.2% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,222 mm³, 44.0% below the reference mean. With a Z-score of -2.88 (0.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,402 mm³, 14.7% below the reference mean. With a Z-score of -1.28 (10.1th percentile), this represents mild atrophy; middle temporal gyrus volume measures 15,477 mm³, 23.3% below the reference mean. With a Z-score of -2.09 (1.8th percentile), this represents significant atrophy. ",
  "text_data": "Age is 85.4 years. Gender is Male. Education: 20 years. MMSE: 25.0. MoCA: 21.0. Logical Memory: 7.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.05 SUVR (normal ); Amyloid beta: 1338.00 pg/mL (normal ); Total tau: 181.00 pg/mL (normal ); Phosphorylated tau: 16.17 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the hippocampus, entorhinal cortex, and middle temporal gyrus—key regions affected in Alzheimer's disease—along with moderate whole-brain atrophy. However, CSF biomarkers (Aβ, T-tau, P-tau) and amyloid PET (AV45) are normal, ruling out Alzheimer's pathology. The MMSE (25) and MoCA (21) suggest mild cognitive impairment (MCI), but the absence of biomarker support for AD or other neurodegenerative causes lowers diagnostic certainty.  \n\n**Diagnosis:** **MCI** (likely non-amnestic or non-AD etiology, given preserved Aβ/tau).  \n**Confidence:** **Medium** (due to conflicting imaging and biomarker findings; age-related atrophy or non-AD neurodegeneration possible).",
  "timestamp": "2025-07-26T03:29:12.072506"
}