{
  "ptid_time": "002_S_4473_2012-02-10",
  "img_path": "/data/qiuhui/data/adni/images/002_S_4473/2012-02-10/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 77,138 mm³, 100.3% above the reference mean. With a Z-score of 2.40 (99.2th percentile), this represents significant enlargement; hippocampal volume measures 9,544 mm³, 26.3% above the reference mean. With a Z-score of 2.56 (99.5th percentile), this represents significant enlargement; whole brain volume measures 1,193,200 mm³, 10.5% above the reference mean. With a Z-score of 1.37 (91.4th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,413 mm³, 7.6% above the reference mean. With a Z-score of 0.52 (69.7th percentile), this represents normal volume ; fusiform gyrus volume measures 21,443 mm³, 13.8% above the reference mean. With a Z-score of 1.18 (88.1th percentile), this represents mild enlargement; middle temporal gyrus volume measures 23,745 mm³, 11.3% above the reference mean. With a Z-score of 1.01 (84.5th percentile), this represents mild enlargement. ",
  "text_data": "Age is 74.8 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Hepatic; Musculoskeletal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 27.0. MoCA: 22.0. Logical Memory: 11.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.43 SUVR (significant elevated); Amyloid beta: 998.80 pg/mL (normal ); Total tau: 380.40 pg/mL (moderate elevated); Phosphorylated tau: 40.95 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The data shows significant ventricular enlargement (Z-score 2.40) and hippocampal enlargement (Z-score 2.56), which are atypical for Alzheimer's but may suggest other neurodegenerative processes. Elevated P-tau and AV45 (amyloid PET) indicate amyloid pathology, while the MoCA score of 22 suggests mild cognitive impairment. Aβ is normal, but tau markers are elevated, which may point toward tauopathy or mixed pathology.  \n\nDiagnosis: **MCI** (Mild Cognitive Impairment)  \nConfidence: **Medium** (due to conflicting imaging findings—unexpected hippocampal enlargement—and biomarker profile)",
  "timestamp": "2025-07-25T20:28:10.468347"
}