{
  "ptid_time": "002_S_4270_2011-10-11",
  "img_path": "/data/qiuhui/data/adni/images/002_S_4270/2011-10-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,832 mm³, 17.0% above the reference mean. With a Z-score of 0.39 (65.1th percentile), this represents normal volume ; hippocampal volume measures 6,604 mm³, 7.2% below the reference mean. With a Z-score of -0.66 (25.5th percentile), this represents normal volume ; whole brain volume measures 1,039,380 mm³, 6.6% above the reference mean. With a Z-score of 0.84 (79.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,978 mm³, 18.9% below the reference mean. With a Z-score of -1.16 (12.3th percentile), this represents mild atrophy; fusiform gyrus volume measures 19,234 mm³, 13.1% above the reference mean. With a Z-score of 1.19 (88.3th percentile), this represents mild enlargement; middle temporal gyrus volume measures 19,372 mm³, 1.1% above the reference mean. With a Z-score of 0.09 (53.7th percentile), this represents normal volume . ",
  "text_data": "Age is 74.6 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 28.0. MoCA: 24.0. Logical Memory: 13.0. Laboratory findings: . APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.66 SUVR (profound elevated); Amyloid beta: 479.70 pg/mL (mild reduced); Total tau: 182.40 pg/mL (normal ); Phosphorylated tau: 19.03 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild atrophy in the entorhinal cortex (Z-score -1.16, 12.3th percentile), which is an early marker of Alzheimer's pathology, alongside mildly reduced Aβ and profoundly elevated AV45 (indicating amyloid deposition). However, hippocampal volume is only slightly reduced (Z-score -0.66, 25.5th percentile), and other brain regions are normal or enlarged. Cognitive scores (MMSE 28, MoCA 24) suggest mild cognitive impairment rather than dementia.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—entorhinal atrophy and AV45 elevation suggest early AD, but cognitive scores are borderline and other volumes are largely preserved).",
  "timestamp": "2025-07-25T20:26:42.322990"
}