{
  "ptid_time": "006_S_4960_2012-10-09",
  "img_path": "/data/qiuhui/data/adni/images/006_S_4960/2012-10-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 21,642 mm³, 13.5% below the reference mean. With a Z-score of -0.18 (42.9th percentile), this represents normal volume ; hippocampal volume measures 9,114 mm³.; whole brain volume measures 1,147,580 mm³, 3.7% below the reference mean. With a Z-score of -0.69 (24.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,146 mm³, 21.4% below the reference mean. With a Z-score of -1.88 (3.0th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,197 mm³, 17.5% below the reference mean. With a Z-score of -2.66 (0.4th percentile), this represents significant atrophy; middle temporal gyrus volume measures 20,189 mm³.. ",
  "text_data": "Age is 59.6 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Respiratory; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 25.0. MoCA: 19.0. Logical Memory: 6.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 0.97 SUVR (normal ); Total tau: 185.40 pg/mL (normal ); Phosphorylated tau: 16.39 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The patient shows significant atrophy in the entorhinal cortex (Z-score -1.88, 3rd percentile) and fusiform gyrus (Z-score -2.66, 0.4th percentile), which are key regions affected in Alzheimer's disease. Cognitive testing (MoCA 19/30) indicates impairment, while MMSE (25/30) is borderline, suggesting possible early cognitive decline. Biomarkers (normal T-tau, P-tau, and AV45) do not strongly support amyloid pathology, but structural atrophy and cognitive deficits are concerning.  \n\nDiagnosis: **Mild Cognitive Impairment (MCI)**  \nConfidence: **Medium** (due to conflicting biomarker results but clear structural and cognitive deficits)",
  "timestamp": "2025-07-25T21:41:37.809263"
}