{
  "ptid_time": "024_S_4392_2012-01-03",
  "img_path": "/data/qiuhui/data/adni/images/024_S_4392/2012-01-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,743 mm³, 15.5% below the reference mean. With a Z-score of -0.45 (32.7th percentile), this represents normal volume ; hippocampal volume measures 5,565 mm³, 20.1% below the reference mean. With a Z-score of -1.74 (4.1th percentile), this represents moderate atrophy; whole brain volume measures 1,066,970 mm³, 3.7% above the reference mean. With a Z-score of 0.48 (68.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,030 mm³, 23.7% below the reference mean. With a Z-score of -1.55 (6.1th percentile), this represents moderate atrophy; fusiform gyrus volume measures 18,103 mm³, 0.2% above the reference mean. With a Z-score of 0.02 (50.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,055 mm³, 0.6% below the reference mean. With a Z-score of -0.05 (47.9th percentile), this represents normal volume . ",
  "text_data": "Age is 82.4 years. Gender is Male. Education: 12 years. MMSE: 29.0. MoCA: 23.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.68 SUVR (profound elevated); Amyloid beta: 976.60 pg/mL (normal ); Total tau: 372.20 pg/mL (moderate elevated); Phosphorylated tau: 37.26 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate atrophy in the hippocampus and entorhinal cortex, which are key regions affected in Alzheimer's disease (AD). Elevated P-tau and AV45 (amyloid PET) strongly suggest AD pathology, while the MMSE (29) is normal but the MoCA (23) indicates mild cognitive impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI) due to Alzheimer’s disease**  \n**Confidence:** **High**  \n\n*(The diagnosis is MCI rather than dementia because cognitive scores (MMSE) remain near-normal, but biomarker and structural changes align with early AD pathology.)*",
  "timestamp": "2025-07-26T03:20:49.886994"
}