{
  "ptid_time": "099_S_4480_2012-02-17",
  "img_path": "/data/qiuhui/data/adni/images/099_S_4480/2012-02-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 7,571 mm³, 66.1% below the reference mean. With a Z-score of -1.65 (4.9th percentile), this represents moderate atrophy; hippocampal volume measures 7,817 mm³, 1.7% above the reference mean. With a Z-score of 0.19 (57.7th percentile), this represents normal volume ; whole brain volume measures 947,858 mm³, 7.9% below the reference mean. With a Z-score of -0.98 (16.3th percentile), this represents normal volume ; entorhinal cortex volume measures 3,124 mm³, 19.8% below the reference mean. With a Z-score of -1.53 (6.3th percentile), this represents moderate atrophy; fusiform gyrus volume measures 18,730 mm³, 2.9% above the reference mean. With a Z-score of 0.32 (62.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,430 mm³, 19.9% below the reference mean. With a Z-score of -1.77 (3.8th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 63.8 years. Gender is Female. Education: 12 years. Handedness: Left. Race: White. Medical history: Cardiovascular; Musculoskeletal; Gastrointestinal; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. MoCA: 24.0. Logical Memory: 8.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.24 SUVR (mild elevated); Amyloid beta: 682.10 pg/mL (normal ); Total tau: 253.60 pg/mL (normal ); Phosphorylated tau: 23.17 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging shows moderate atrophy in the ventricular volume, entorhinal cortex, and middle temporal gyrus, which are regions commonly affected in Alzheimer's disease. However, cognitive scores (MMSE 29, MoCA 24) are borderline normal/MCI, and CSF biomarkers (Aβ, T-tau, P-tau) are normal, suggesting no strong evidence of amyloid or tau pathology despite mild AV45 elevation.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging and biomarker findings, but cognitive scores suggest early decline)",
  "timestamp": "2025-07-26T11:08:44.454793"
}