{
  "ptid_time": "012_S_5195_2013-06-14",
  "img_path": "/data/qiuhui/data/adni/images/012_S_5195/2013-06-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 7,671 mm³, 65.7% below the reference mean. With a Z-score of -1.64 (5.0th percentile), this represents moderate atrophy; hippocampal volume measures 7,896 mm³, 2.8% above the reference mean. With a Z-score of 0.31 (62.1th percentile), this represents normal volume ; whole brain volume measures 1,004,080 mm³, 2.4% below the reference mean. With a Z-score of -0.30 (38.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,304 mm³, 15.1% below the reference mean. With a Z-score of -1.17 (12.1th percentile), this represents mild atrophy; fusiform gyrus volume measures 20,217 mm³, 11.0% above the reference mean. With a Z-score of 1.24 (89.3th percentile), this represents mild enlargement; middle temporal gyrus volume measures 20,300 mm³, 1.1% below the reference mean. With a Z-score of -0.10 (46.2th percentile), this represents normal volume . ",
  "text_data": "Age is 65.1 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. MoCA: 24.0. Logical Memory: 10.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.04 SUVR (normal ); Total tau: 382.90 pg/mL (moderate elevated); Phosphorylated tau: 32.99 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate ventricular atrophy and mild entorhinal cortex atrophy, which are concerning for early neurodegenerative changes. However, hippocampal and whole-brain volumes are normal, and cognitive scores (MMSE 29, MoCA 24) are borderline for MCI (with MoCA slightly below typical cutoff). Biomarkers (elevated T-tau/P-tau, normal AV45) suggest possible Alzheimer’s pathology but are not definitive.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to mixed imaging findings and borderline cognitive scores; biomarkers support neurodegeneration but not conclusively dementia).",
  "timestamp": "2025-07-25T23:18:12.566343"
}