{
  "ptid_time": "123_S_4806_2014-08-28",
  "img_path": "/data/qiuhui/data/adni/images/123_S_4806/2014-08-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 51,726 mm³, 106.8% above the reference mean. With a Z-score of 1.42 (92.2th percentile), this represents mild enlargement; hippocampal volume measures 7,001 mm³.; whole brain volume measures 1,090,370 mm³, 8.5% below the reference mean. With a Z-score of -1.58 (5.7th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,872 mm³, 3.3% below the reference mean. With a Z-score of -0.29 (38.7th percentile), this represents normal volume ; fusiform gyrus volume measures 19,196 mm³, 7.9% below the reference mean. With a Z-score of -1.20 (11.5th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,355 mm³.. ",
  "text_data": "Age is 57.9 years. Gender is Male. Education: 19 years. MMSE: 28.0. MoCA: 25.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.01 SUVR (normal ); Amyloid beta: 617.80 pg/mL (mild reduced); Total tau: 97.31 pg/mL (moderate reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows moderate whole brain atrophy (Z-score -1.58) and mild hippocampal volume reduction, alongside mild ventricular enlargement, which are suggestive of early neurodegenerative changes. However, cognitive scores (MMSE 28, MoCA 25) remain relatively intact, and biomarkers (Aβ mildly reduced, T-tau moderately reduced, AV45 normal) do not strongly support Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural changes are concerning, but cognitive and biomarker profiles are not definitive for dementia or Alzheimer’s.)",
  "timestamp": "2025-07-26T12:34:36.788049"
}