{
  "ptid_time": "127_S_4765_2012-06-08",
  "img_path": "/data/qiuhui/data/adni/images/127_S_4765/2012-06-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,521 mm³, 49.3% below the reference mean. With a Z-score of -1.18 (11.9th percentile), this represents mild atrophy; hippocampal volume measures 6,996 mm³, 7.4% below the reference mean. With a Z-score of -0.73 (23.4th percentile), this represents normal volume ; whole brain volume measures 1,018,200 mm³, 5.7% below the reference mean. With a Z-score of -0.74 (23.1th percentile), this represents normal volume ; entorhinal cortex volume measures 4,388 mm³, 7.0% above the reference mean. With a Z-score of 0.48 (68.3th percentile), this represents normal volume ; fusiform gyrus volume measures 20,782 mm³, 10.3% above the reference mean. With a Z-score of 0.88 (81.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,900 mm³, 6.7% below the reference mean. With a Z-score of -0.61 (27.2th percentile), this represents normal volume . ",
  "text_data": "Age is 76.0 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Endocrine-Metabolic; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 26.0. MoCA: 20.0. Logical Memory: 9.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.37 SUVR (significant elevated); Amyloid beta: 845.80 pg/mL (normal ); Total tau: 564.20 pg/mL (profound elevated); Phosphorylated tau: 50.75 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild ventricular atrophy but otherwise normal brain volumes, including the hippocampus. However, cognitive testing (MoCA 20) suggests impairment, and biomarkers (elevated T-tau, P-tau, and AV45) indicate amyloid pathology and neurodegeneration, despite normal Aβ.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology)  \n**Confidence:** **Medium** (cognitive scores and biomarkers support MCI, but normal hippocampal volume and Aβ complicate full dementia diagnosis)",
  "timestamp": "2025-07-26T13:21:14.640769"
}