{
  "ptid_time": "035_S_2199_2010-11-29",
  "img_path": "/data/qiuhui/data/adni/images/035_S_2199/2010-11-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 67,633 mm³, 43.9% above the reference mean. With a Z-score of 1.27 (89.9th percentile), this represents mild enlargement; hippocampal volume measures 7,520 mm³, 7.9% above the reference mean. With a Z-score of 0.68 (75.3th percentile), this represents normal volume ; whole brain volume measures 1,127,650 mm³, 9.6% above the reference mean. With a Z-score of 1.25 (89.5th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,871 mm³, 2.5% below the reference mean. With a Z-score of -0.16 (43.6th percentile), this represents normal volume ; fusiform gyrus volume measures 16,254 mm³, 10.0% below the reference mean. With a Z-score of -0.87 (19.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,247 mm³, 5.3% above the reference mean. With a Z-score of 0.48 (68.4th percentile), this represents normal volume . ",
  "text_data": "Age is 83.2 years. Gender is Male. Education: 12 years. Handedness: Right. Race: White. Medical history: Neurologic; Cardiovascular; Musculoskeletal; Renal-Genitourinary; Smoking; Malignancy; Major Surgical Procedures. MMSE: 25.0. MoCA: 22.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.95 SUVR (mild reduced); Amyloid beta: 1523.00 pg/mL (mild elevated); Total tau: 224.30 pg/mL (normal ); Phosphorylated tau: 18.93 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mild ventricular enlargement (consistent with age-related atrophy) but otherwise largely normal brain volumes, including the hippocampus and entorhinal cortex. The MMSE (25) and MoCA (22) scores suggest mild cognitive impairment (MCI), supported by mildly elevated Aβ (though tau markers are normal). The absence of APOE4 and only mild biomarker abnormalities suggest a slower progression.  \n\n**Diagnosis:** **MCI** (likely amnestic subtype, given hippocampal sparing but mild Aβ elevation).  \n\n**Confidence:** **Medium** (clinical scores and Aβ support MCI, but normal tau and hippocampal volume reduce certainty of imminent dementia progression).",
  "timestamp": "2025-07-26T05:53:55.477318"
}