{
  "ptid_time": "011_S_2274_2013-02-06",
  "img_path": "/data/qiuhui/data/adni/images/011_S_2274/2013-02-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 67,764 mm³, 125.7% above the reference mean. With a Z-score of 2.99 (99.9th percentile), this represents significant enlargement; hippocampal volume measures 6,918 mm³, 13.8% below the reference mean. With a Z-score of -1.38 (8.4th percentile), this represents mild atrophy; whole brain volume measures 1,409,380 mm³, 24.2% above the reference mean. With a Z-score of 3.43 (100.0th percentile), this represents profound enlargement; entorhinal cortex volume measures 2,084 mm³, 51.1% below the reference mean. With a Z-score of -3.54 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 18,791 mm³, 5.6% below the reference mean. With a Z-score of -0.47 (32.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,527 mm³, 0.5% above the reference mean. With a Z-score of 0.04 (51.7th percentile), this represents normal volume . ",
  "text_data": "Age is 66.0 years. Gender is Male. Education: 18 years. MMSE: 25.0. MoCA: 22.0. Logical Memory: 1.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.21 SUVR (mild elevated); Amyloid beta: 633.40 pg/mL (mild reduced); Total tau: 258.80 pg/mL (normal ); Phosphorylated tau: 25.91 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.99) and profound entorhinal cortex atrophy (Z-score -3.54), both strong indicators of neurodegeneration. Hippocampal atrophy is mild (Z-score -1.38), while Aβ is mildly reduced and AV45 is mildly elevated, suggesting early amyloid pathology. The MMSE (25) and MoCA (22) scores indicate mild cognitive impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—normal tau but amyloid changes—and only mild cognitive decline)",
  "timestamp": "2025-07-25T22:52:21.660437"
}