{
  "ptid_time": "023_S_2068_2010-12-01",
  "img_path": "/data/qiuhui/data/adni/images/023_S_2068/2010-12-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 53,934 mm³, 14.7% above the reference mean. With a Z-score of 0.43 (66.5th percentile), this represents normal volume ; hippocampal volume measures 6,263 mm³, 10.1% below the reference mean. With a Z-score of -0.87 (19.1th percentile), this represents normal volume ; whole brain volume measures 1,014,750 mm³, 1.4% below the reference mean. With a Z-score of -0.18 (42.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,906 mm³, 1.6% below the reference mean. With a Z-score of -0.10 (45.9th percentile), this represents normal volume ; fusiform gyrus volume measures 18,722 mm³, 3.6% above the reference mean. With a Z-score of 0.31 (62.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,438 mm³, 8.6% below the reference mean. With a Z-score of -0.77 (22.1th percentile), this represents normal volume . ",
  "text_data": "Age is 83.1 years. Gender is Male. Education: 20 years. Handedness: Right. Race: More than one race. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Hepatic; Dermatologic-Connective Tissue; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 28.0. MoCA: 21.0. Logical Memory: 9.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.57 SUVR (profound elevated); Amyloid beta: 722.80 pg/mL (normal ); Total tau: 322.90 pg/mL (mild elevated); Phosphorylated tau: 32.76 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volumes are largely within normal ranges, though the hippocampal volume is slightly reduced (10.1% below mean, Z-score -0.87). The MMSE is normal (28/30), but the MoCA is borderline (21/30), suggesting possible mild cognitive impairment. Biomarkers show normal Aβ but elevated tau and AV45 (amyloid PET), which may indicate early Alzheimer's pathology despite preserved cognition.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to borderline MoCA and biomarker discordance—elevated tau/AV45 but normal Aβ and mostly normal volumetrics)",
  "timestamp": "2025-07-26T02:59:01.255449"
}