{
  "ptid_time": "109_S_4594_2012-03-30",
  "img_path": "/data/qiuhui/data/adni/images/109_S_4594/2012-03-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 18,339 mm³, 38.9% below the reference mean. With a Z-score of -0.92 (17.8th percentile), this represents normal volume ; hippocampal volume measures 7,879 mm³, 1.8% below the reference mean. With a Z-score of -0.18 (42.7th percentile), this represents normal volume ; whole brain volume measures 1,173,530 mm³, 3.4% above the reference mean. With a Z-score of 0.49 (68.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,488 mm³, 18.2% below the reference mean. With a Z-score of -1.26 (10.4th percentile), this represents mild atrophy; fusiform gyrus volume measures 20,101 mm³, 1.0% above the reference mean. With a Z-score of 0.08 (53.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,209 mm³, 3.6% above the reference mean. With a Z-score of 0.29 (61.5th percentile), this represents normal volume . ",
  "text_data": "Age is 62.1 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Respiratory; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 25.0. MoCA: 26.0. Logical Memory: 10.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 0.94 SUVR (mild reduced); Total tau: 184.20 pg/mL (normal ); Phosphorylated tau: 15.13 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows mild atrophy (Z-score -1.26, 10.4th percentile), which is an early marker of Alzheimer's pathology, while other brain regions (hippocampus, whole brain, fusiform gyrus, middle temporal gyrus) are within normal ranges. Cognitive scores (MMSE 25, MoCA 26) are borderline but not definitively impaired. Biomarkers (normal T-tau, P-tau, mildly reduced AV45) suggest early amyloid deposition but no significant neurodegeneration yet.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to borderline cognitive scores and isolated entorhinal atrophy without widespread neurodegeneration or clear biomarker abnormalities).",
  "timestamp": "2025-07-26T11:35:33.807246"
}