{
  "ptid_time": "031_S_4149_2011-08-05",
  "img_path": "/data/qiuhui/data/adni/images/031_S_4149/2011-08-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,247 mm³, 5.9% below the reference mean. With a Z-score of -0.14 (44.4th percentile), this represents normal volume ; hippocampal volume measures 7,913 mm³, 4.7% above the reference mean. With a Z-score of 0.46 (67.6th percentile), this represents normal volume ; whole brain volume measures 1,172,190 mm³, 8.6% above the reference mean. With a Z-score of 1.12 (86.8th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,910 mm³, 4.6% below the reference mean. With a Z-score of -0.32 (37.6th percentile), this represents normal volume ; fusiform gyrus volume measures 17,576 mm³, 6.7% below the reference mean. With a Z-score of -0.57 (28.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 24,291 mm³, 13.8% above the reference mean. With a Z-score of 1.24 (89.3th percentile), this represents mild enlargement. ",
  "text_data": "Age is 73.3 years. Gender is Male. Education: 14 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 24.0. MoCA: 21.0. Logical Memory: 5.0. Laboratory findings: . APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.16 SUVR (normal ); Amyloid beta: 958.30 pg/mL (normal ); Total tau: 202.90 pg/mL (normal ); Phosphorylated tau: 18.54 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with some mild enlargement in whole brain and middle temporal gyrus volumes. Cognitive scores (MMSE 24, MoCA 21) suggest mild impairment, but CSF biomarkers (Aβ, T-tau, P-tau) and amyloid PET (AV45) are normal, making Alzheimer's pathology unlikely.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely non-amnestic or non-AD etiology given normal biomarkers).  \n\n**Confidence:** **Medium** (cognitive scores indicate impairment, but normal biomarkers and stable brain volumes suggest non-progressive or non-neurodegenerative causes).",
  "timestamp": "2025-07-26T04:46:51.319196"
}