{
  "ptid_time": "002_S_4225_2011-12-26",
  "img_path": "/data/qiuhui/data/adni/images/002_S_4225/2011-12-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,319 mm³, 31.0% above the reference mean. With a Z-score of 0.74 (76.9th percentile), this represents normal volume ; hippocampal volume measures 8,762 mm³, 9.2% above the reference mean. With a Z-score of 0.92 (82.0th percentile), this represents normal volume ; whole brain volume measures 1,280,620 mm³, 12.9% above the reference mean. With a Z-score of 1.82 (96.6th percentile), this represents moderate enlargement; entorhinal cortex volume measures 4,104 mm³, 3.7% below the reference mean. With a Z-score of -0.26 (39.8th percentile), this represents normal volume ; fusiform gyrus volume measures 23,170 mm³, 16.4% above the reference mean. With a Z-score of 1.36 (91.3th percentile), this represents mild enlargement; middle temporal gyrus volume measures 29,435 mm³, 31.3% above the reference mean. With a Z-score of 2.58 (99.5th percentile), this represents significant enlargement. ",
  "text_data": "Age is 69.9 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Musculoskeletal; Gastrointestinal; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 28.0. MoCA: 25.0. Logical Memory: 12.0. Laboratory findings: Total Bilirubin: 0.90 (significant elevated). APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.52 SUVR (profound elevated); Amyloid beta: 713.70 pg/mL (normal ); Total tau: 371.60 pg/mL (moderate elevated); Phosphorylated tau: 38.07 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows normal to enlarged volumes in most regions, with no significant atrophy in key areas like the hippocampus and entorhinal cortex. However, the biomarker profile (elevated T-tau, P-tau, and AV45) suggests amyloid pathology and neurodegeneration, while cognitive scores (MMSE 28, MoCA 25) are borderline for MCI but not dementia.  \n**Diagnosis:** **MCI** (likely due to Alzheimer's pathology given biomarker findings).  \n**Confidence:** **Medium** (cognitive scores are near-normal, but biomarkers strongly suggest early neurodegenerative changes).",
  "timestamp": "2025-07-25T20:22:32.667051"
}