{
  "ptid_time": "018_S_4889_2012-08-10",
  "img_path": "/data/qiuhui/data/adni/images/018_S_4889/2012-08-10/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 59,389 mm³, 54.2% above the reference mean. With a Z-score of 1.30 (90.3th percentile), this represents mild enlargement; hippocampal volume measures 7,539 mm³, 0.3% below the reference mean. With a Z-score of -0.03 (49.0th percentile), this represents normal volume ; whole brain volume measures 1,167,210 mm³, 8.1% above the reference mean. With a Z-score of 1.06 (85.5th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,576 mm³, 11.6% above the reference mean. With a Z-score of 0.79 (78.4th percentile), this represents normal volume ; fusiform gyrus volume measures 18,402 mm³, 2.3% below the reference mean. With a Z-score of -0.20 (42.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,481 mm³, 0.7% above the reference mean. With a Z-score of 0.06 (52.4th percentile), this represents normal volume . ",
  "text_data": "Age is 75.6 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Renal-Genitourinary; Smoking; Major Surgical Procedures. MMSE: 28.0. MoCA: 21.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.03 SUVR (normal ); Amyloid beta: 956.20 pg/mL (normal ); Total tau: 123.60 pg/mL (mild reduced); Phosphorylated tau: 9.84 pg/mL (moderate reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild ventricular enlargement but otherwise normal hippocampal, entorhinal, fusiform gyrus, and middle temporal gyrus volumes. The MMSE is normal (28/30), but the MoCA (21/30) suggests mild cognitive impairment. Biomarkers (Aβ normal, reduced T-tau and P-tau, normal AV45) do not strongly support Alzheimer’s pathology.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (due to the discrepancy between MMSE and MoCA, and lack of clear biomarker evidence for neurodegeneration)",
  "timestamp": "2025-07-26T01:01:23.338883"
}