{
  "ptid_time": "035_S_2074_2010-11-19",
  "img_path": "/data/qiuhui/data/adni/images/035_S_2074/2010-11-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 24,300 mm³, 19.1% below the reference mean. With a Z-score of -0.45 (32.5th percentile), this represents normal volume ; hippocampal volume measures 7,687 mm³, 4.2% below the reference mean. With a Z-score of -0.42 (33.6th percentile), this represents normal volume ; whole brain volume measures 1,087,640 mm³, 4.1% below the reference mean. With a Z-score of -0.59 (27.9th percentile), this represents normal volume ; entorhinal cortex volume measures 3,335 mm³, 21.8% below the reference mean. With a Z-score of -1.51 (6.6th percentile), this represents moderate atrophy; fusiform gyrus volume measures 20,718 mm³, 4.1% above the reference mean. With a Z-score of 0.34 (63.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 24,119 mm³, 7.6% above the reference mean. With a Z-score of 0.63 (73.5th percentile), this represents normal volume . ",
  "text_data": "Age is 62.0 years. Gender is Male. Education: 16 years. Handedness: Left. Race: White. Medical history: Psychiatric; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Smoking; Malignancy; Major Surgical Procedures. MMSE: 28.0. MoCA: 26.0. Logical Memory: 10.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.01 SUVR (normal ); Amyloid beta: 1641.00 pg/mL (moderate elevated); Total tau: 186.50 pg/mL (normal ); Phosphorylated tau: 15.39 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.51, 6.6th percentile), which is a key early marker of Alzheimer’s pathology, while other brain regions (hippocampus, whole brain) are within normal ranges. Cognitive scores (MMSE 28, MoCA 26) are intact, but moderate Aβ elevation suggests amyloid pathology.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to structural atrophy in a critical AD-related region and biomarker evidence, despite normal cognition).  \n**Confidence:** **Medium** (clinical cognitive scores are normal, but biomarker/structural changes suggest early disease).  \n\n*Note: Progression to dementia is likely if atrophy spreads or cognition declines, but current data don’t meet dementia criteria.*",
  "timestamp": "2025-07-26T05:52:54.511452"
}