{
  "ptid_time": "009_S_4958_2012-10-04",
  "img_path": "/data/qiuhui/data/adni/images/009_S_4958/2012-10-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 62,425 mm³, 107.9% above the reference mean. With a Z-score of 2.56 (99.5th percentile), this represents significant enlargement; hippocampal volume measures 6,808 mm³, 15.2% below the reference mean. With a Z-score of -1.52 (6.5th percentile), this represents moderate atrophy; whole brain volume measures 1,013,430 mm³, 10.7% below the reference mean. With a Z-score of -1.51 (6.5th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,610 mm³, 15.3% below the reference mean. With a Z-score of -1.06 (14.5th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,501 mm³, 17.1% below the reference mean. With a Z-score of -1.42 (7.7th percentile), this represents mild atrophy; middle temporal gyrus volume measures 19,609 mm³, 12.5% below the reference mean. With a Z-score of -1.03 (15.1th percentile), this represents mild atrophy. ",
  "text_data": "Age is 69.5 years. Gender is Male. Education: 20 years. Handedness: Left. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Hematopoietic-Lymphatic. MMSE: 28.0. MoCA: 25.0. Logical Memory: 11.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.19 SUVR (normal ); Amyloid beta: 764.80 pg/mL (normal ); Total tau: 122.20 pg/mL (mild reduced); Phosphorylated tau: 10.22 pg/mL (moderate reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant ventricular enlargement (consistent with atrophy) and moderate hippocampal atrophy, alongside mild-to-moderate atrophy in other key regions (whole brain, entorhinal cortex, fusiform gyrus, middle temporal gyrus). However, cognitive scores (MMSE 28, MoCA 25) are near-normal, and biomarkers (Aβ normal, reduced tau) do not strongly support Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural changes suggest neurodegeneration, but cognitive and biomarker profiles are atypical for typical AD progression).  \n\n*Note:* The discrepancy between imaging (suggestive of neurodegeneration) and biomarkers/cognition warrants further investigation for non-AD etiologies (e.g., vascular, LATE, or other tauopathies).",
  "timestamp": "2025-07-25T22:24:52.312432"
}