{
  "ptid_time": "018_S_2155_2010-12-02",
  "img_path": "/data/qiuhui/data/adni/images/018_S_2155/2010-12-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 12,574 mm³, 43.7% below the reference mean. With a Z-score of -1.09 (13.7th percentile), this represents mild atrophy; hippocampal volume measures 7,712 mm³, 0.4% above the reference mean. With a Z-score of 0.04 (51.6th percentile), this represents normal volume ; whole brain volume measures 1,083,240 mm³, 5.3% above the reference mean. With a Z-score of 0.65 (74.4th percentile), this represents normal volume ; entorhinal cortex volume measures 5,057 mm³, 29.9% above the reference mean. With a Z-score of 2.32 (99.0th percentile), this represents significant enlargement; fusiform gyrus volume measures 20,785 mm³, 14.1% above the reference mean. With a Z-score of 1.59 (94.4th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 21,346 mm³, 4.0% above the reference mean. With a Z-score of 0.36 (64.0th percentile), this represents normal volume . ",
  "text_data": "Age is 68.9 years. Gender is Female. Education: 14 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 27.0. MoCA: 22.0. Logical Memory: 9.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.28 SUVR (moderate elevated); Amyloid beta: 539.60 pg/mL (mild reduced); Total tau: 811.70 pg/mL (profound elevated); Phosphorylated tau: 82.04 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging shows mild ventricular atrophy but otherwise normal or enlarged brain volumes, particularly in the entorhinal cortex and fusiform gyrus. However, the clinical biomarkers (profoundly elevated T-tau and P-tau, moderately elevated AV45, and mildly reduced Aβ) strongly suggest Alzheimer's pathology. The cognitive scores (MMSE 27, MoCA 22) indicate mild cognitive impairment.  \n\n**Diagnosis:** **MCI (likely due to Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T00:53:49.261203"
}