{
  "ptid_time": "016_S_4121_2011-10-13",
  "img_path": "/data/qiuhui/data/adni/images/016_S_4121/2011-10-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,628 mm³, 30.6% below the reference mean. With a Z-score of -0.89 (18.7th percentile), this represents normal volume ; hippocampal volume measures 6,456 mm³, 7.3% below the reference mean. With a Z-score of -0.64 (26.3th percentile), this represents normal volume ; whole brain volume measures 961,057 mm³, 6.6% below the reference mean. With a Z-score of -0.87 (19.3th percentile), this represents normal volume ; entorhinal cortex volume measures 4,113 mm³, 3.6% above the reference mean. With a Z-score of 0.24 (59.4th percentile), this represents normal volume ; fusiform gyrus volume measures 19,714 mm³, 9.1% above the reference mean. With a Z-score of 0.79 (78.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,757 mm³, 7.0% below the reference mean. With a Z-score of -0.63 (26.5th percentile), this represents normal volume . ",
  "text_data": "Age is 89.0 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Endocrine-Metabolic; Smoking; Major Surgical Procedures. MMSE: 27.0. MoCA: 19.0. Logical Memory: 9.0. Laboratory findings: Urea Nitrogen: 29.00 (significant elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.95 SUVR (mild reduced); Amyloid beta: 1345.00 pg/mL (normal ); Total tau: 304.80 pg/mL (normal ); Phosphorylated tau: 26.15 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are all within normal ranges, with no significant atrophy in key regions like the hippocampus or entorhinal cortex. However, the MoCA score of 19 suggests mild cognitive impairment (MCI), while the MMSE of 27 is borderline normal, and biomarker levels (Aβ, T-tau, P-tau, AV45) do not strongly support Alzheimer's pathology.  \n\n**Diagnosis:** MCI  \n**Confidence:** Medium  \n\n*(Note: The discrepancy between MMSE and MoCA, along with normal biomarkers, makes Alzheimer's less likely, but the MoCA score is concerning for MCI. Age and normal imaging reduce confidence in a dementia diagnosis.)*",
  "timestamp": "2025-07-26T00:25:26.742321"
}