{
  "ptid_time": "041_S_4876_2012-08-14",
  "img_path": "/data/qiuhui/data/adni/images/041_S_4876/2012-08-14/t1.nii.gz",
  "img_finding": "Image findings: hippocampal volume measures 6,394 mm³, 15.4% below the reference mean. With a Z-score of -1.50 (6.6th percentile), this represents moderate atrophy; whole brain volume measures 1,167,430 mm³, 8.2% above the reference mean. With a Z-score of 1.06 (85.5th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,562 mm³, 11.3% above the reference mean. With a Z-score of 0.76 (77.7th percentile), this represents normal volume ; fusiform gyrus volume measures 21,775 mm³, 15.6% above the reference mean. With a Z-score of 1.33 (90.8th percentile), this represents mild enlargement; middle temporal gyrus volume measures 20,309 mm³, 4.8% below the reference mean. With a Z-score of -0.43 (33.2th percentile), this represents normal volume . ",
  "text_data": "Age is 74.2 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Neurologic; Cardiovascular; Major Surgical Procedures. MMSE: 30.0. MoCA: 25.0. Logical Memory: 9.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 0.97 SUVR (normal ); Amyloid beta: 1432.00 pg/mL (mild elevated); Total tau: 228.90 pg/mL (normal ); Phosphorylated tau: 19.43 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate hippocampal atrophy (Z-score -1.50, 6.6th percentile), which is a key biomarker for Alzheimer’s disease (AD), alongside mildly elevated Aβ (amyloid burden). However, cognitive scores (MMSE 30, MoCA 25) are largely intact, with no significant impairment in daily functioning. Other brain regions (entorhinal cortex, fusiform gyrus) are normal or enlarged, and CSF biomarkers (T-tau, P-tau) are normal.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology given hippocampal atrophy and Aβ elevation, but cognition is not yet impaired enough for dementia).  \n\n**Confidence:** **Medium** (hippocampal atrophy and Aβ suggest early AD, but normal tau and preserved cognition make progression uncertain).",
  "timestamp": "2025-07-26T07:21:01.266298"
}