{
  "ptid_time": "127_S_4240_2011-09-23",
  "img_path": "/data/qiuhui/data/adni/images/127_S_4240/2011-09-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,852 mm³, 4.3% below the reference mean. With a Z-score of -0.10 (45.9th percentile), this represents normal volume ; hippocampal volume measures 5,341 mm³, 29.3% below the reference mean. With a Z-score of -2.86 (0.2th percentile), this represents significant atrophy; whole brain volume measures 1,002,720 mm³, 7.1% below the reference mean. With a Z-score of -0.92 (17.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,058 mm³, 25.4% below the reference mean. With a Z-score of -1.72 (4.2th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,680 mm³, 22.1% below the reference mean. With a Z-score of -1.88 (3.0th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 19,472 mm³, 8.7% below the reference mean. With a Z-score of -0.79 (21.6th percentile), this represents normal volume . ",
  "text_data": "Age is 70.8 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Respiratory; Musculoskeletal; Endocrine-Metabolic; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 28.0. MoCA: 23.0. Logical Memory: 0.0. Laboratory findings: Vitamin B12: 981.00 (significant elevated); Neutrophils: 77.00 (significant elevated); Lymphocytes: 13.30 (significant reduced); Lymphocytes: 0.74 (significant reduced). APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.51 SUVR (profound elevated); Amyloid beta: 337.50 pg/mL (moderate reduced); Total tau: 270.90 pg/mL (normal ); Phosphorylated tau: 27.73 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant hippocampal atrophy (Z-score -2.86, 0.2th percentile) and moderate atrophy in the entorhinal cortex and fusiform gyrus, which are key regions affected in Alzheimer's disease. Elevated AV45 (amyloid PET) and moderately reduced Aβ (CSF) support amyloid pathology, while cognitive scores (MMSE 28, MoCA 23) suggest mild cognitive impairment (MCI) rather than dementia.  \n\n**Diagnosis:** **MCI (likely due to Alzheimer’s pathology)**  \n**Confidence:** **High**  \n\n(APOE4 homozygosity, amyloid positivity, and medial temporal atrophy strongly align with prodromal AD.)",
  "timestamp": "2025-07-26T13:17:04.763210"
}