{
  "ptid_time": "153_S_4159_2011-08-17",
  "img_path": "/data/qiuhui/data/adni/images/153_S_4159/2011-08-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 29,515 mm³, 5.2% above the reference mean. With a Z-score of 0.12 (54.7th percentile), this represents normal volume ; hippocampal volume measures 6,659 mm³, 6.4% below the reference mean. With a Z-score of -0.59 (27.9th percentile), this represents normal volume ; whole brain volume measures 1,044,320 mm³, 7.1% above the reference mean. With a Z-score of 0.90 (81.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,450 mm³, 6.1% below the reference mean. With a Z-score of -0.37 (35.5th percentile), this represents normal volume ; fusiform gyrus volume measures 19,814 mm³, 16.5% above the reference mean. With a Z-score of 1.50 (93.3th percentile), this represents mild enlargement; middle temporal gyrus volume measures 19,626 mm³, 2.4% above the reference mean. With a Z-score of 0.21 (58.2th percentile), this represents normal volume . ",
  "text_data": "Age is 71.0 years. Gender is Female. Education: 19 years. Handedness: Right. Race: White. Medical history: Renal-Genitourinary; Smoking; Malignancy; Major Surgical Procedures. MMSE: 30.0. MoCA: 25.0. Logical Memory: 10.0. Laboratory findings: Vitamin B12: 4346.00 (profound elevated); MCH: 34.00 (significant elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.08 SUVR (normal ); Amyloid beta: 1380.00 pg/mL (normal ); Total tau: 194.90 pg/mL (normal ); Phosphorylated tau: 17.89 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with only mild deviations (e.g., slightly reduced hippocampal and entorhinal cortex volumes, but still within normal Z-scores). Cognitive testing shows a perfect MMSE but a mildly reduced MoCA (25/30), though biomarkers (Aβ, tau, AV45) are normal. No APOE4 risk allele is present.  \n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (MoCA is borderline, but structural and biomarker data do not suggest neurodegeneration or amyloid pathology).",
  "timestamp": "2025-07-26T17:12:49.754058"
}