{
  "ptid_time": "072_S_4103_2011-07-20",
  "img_path": "/data/qiuhui/data/adni/images/072_S_4103/2011-07-20/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 28,858 mm³, 25.1% below the reference mean. With a Z-score of -0.60 (27.4th percentile), this represents normal volume ; hippocampal volume measures 5,653 mm³, 25.2% below the reference mean. With a Z-score of -2.46 (0.7th percentile), this represents significant atrophy; whole brain volume measures 847,861 mm³, 21.5% below the reference mean. With a Z-score of -2.78 (0.3th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,224 mm³, 21.4% below the reference mean. With a Z-score of -1.45 (7.4th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,830 mm³, 16.0% below the reference mean. With a Z-score of -1.36 (8.7th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,878 mm³, 20.9% below the reference mean. With a Z-score of -1.88 (3.0th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 70.9 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. MoCA: 24.0. Logical Memory: 13.0. Laboratory findings: Monocytes: 0.71 (significant elevated); MCH: 34.00 (significant elevated); Monocytes: 12.40 (profound elevated); Alkaline Phosphatase: 117.00 (significant elevated); GGT: 174.00 (profound elevated); ALT (SGPT): 57.00 (profound elevated); AST (SGOT): 43.00 (profound elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.03 SUVR (normal ); Amyloid beta: 1432.00 pg/mL (mild elevated); Total tau: 188.40 pg/mL (normal ); Phosphorylated tau: 17.69 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the hippocampus and whole brain, along with moderate atrophy in the middle temporal gyrus—key regions affected in Alzheimer’s disease. Despite normal Aβ and tau biomarkers, the cognitive scores (MoCA 24, MMSE 29) suggest subtle impairment, aligning with MCI.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (due to conflicting biomarker and imaging findings, but strong structural atrophy supports MCI)",
  "timestamp": "2025-07-26T09:17:20.174464"
}