{
  "ptid_time": "073_S_4853_2012-07-11",
  "img_path": "/data/qiuhui/data/adni/images/073_S_4853/2012-07-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 49,613 mm³, 76.8% above the reference mean. With a Z-score of 1.76 (96.1th percentile), this represents moderate enlargement; hippocampal volume measures 6,866 mm³, 3.5% below the reference mean. With a Z-score of -0.32 (37.4th percentile), this represents normal volume ; whole brain volume measures 1,080,420 mm³, 10.9% above the reference mean. With a Z-score of 1.37 (91.4th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,191 mm³, 13.1% below the reference mean. With a Z-score of -0.81 (21.0th percentile), this represents normal volume ; fusiform gyrus volume measures 18,133 mm³, 6.6% above the reference mean. With a Z-score of 0.60 (72.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,019 mm³, 4.4% above the reference mean. With a Z-score of 0.38 (65.0th percentile), this represents normal volume . ",
  "text_data": "Age is 70.9 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Cardiovascular; Endocrine-Metabolic; Renal-Genitourinary; Major Surgical Procedures. MMSE: 26.0. MoCA: 23.0. Logical Memory: 5.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.37 SUVR (significant elevated); Amyloid beta: 691.90 pg/mL (normal ); Total tau: 741.60 pg/mL (profound elevated); Phosphorylated tau: 83.30 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows moderate ventricular enlargement (suggesting atrophy) and normal hippocampal volume, but the entorhinal cortex is slightly reduced. Cognitive scores (MMSE 26, MoCA 23) are borderline, with biomarkers indicating significant tau pathology (elevated T-tau, P-tau) and amyloid deposition (elevated AV45), despite normal Aβ. This suggests neurodegenerative changes consistent with early Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI) (likely due to Alzheimer’s disease)**  \n**Confidence:** **Medium** (Cognitive scores are borderline, but biomarker profile strongly supports underlying AD pathology; however, hippocampal volume is still normal, which may indicate early-stage disease.)",
  "timestamp": "2025-07-26T09:53:41.467269"
}