{
  "ptid_time": "094_S_4630_2012-04-03",
  "img_path": "/data/qiuhui/data/adni/images/094_S_4630/2012-04-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,017 mm³, 23.8% below the reference mean. With a Z-score of -0.60 (27.6th percentile), this represents normal volume ; hippocampal volume measures 7,033 mm³, 8.5% below the reference mean. With a Z-score of -0.95 (17.1th percentile), this represents normal volume ; whole brain volume measures 909,926 mm³, 11.6% below the reference mean. With a Z-score of -1.44 (7.5th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,099 mm³, 20.4% below the reference mean. With a Z-score of -1.58 (5.7th percentile), this represents moderate atrophy; fusiform gyrus volume measures 15,152 mm³, 16.8% below the reference mean. With a Z-score of -1.89 (2.9th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 18,554 mm³, 9.6% below the reference mean. With a Z-score of -0.85 (19.7th percentile), this represents normal volume . ",
  "text_data": "Age is 65.4 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Respiratory; Hepatic; Endocrine-Metabolic; Gastrointestinal; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 30.0. MoCA: 25.0. Logical Memory: 7.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.99 SUVR (normal ); Amyloid beta: 1533.00 pg/mL (mild elevated); Total tau: 183.30 pg/mL (normal ); Phosphorylated tau: 16.17 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild to moderate atrophy in key regions (whole brain, entorhinal cortex, fusiform gyrus), while hippocampal volume is within normal limits. Cognitive testing (MMSE 30, MoCA 25) suggests intact global cognition but possible subtle deficits. Biomarkers indicate mild Aβ elevation without tauopathy, which may suggest early amyloid deposition but not yet full Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Atrophy in AD-vulnerable regions and borderline MoCA raise concern, but normal tau and intact MMSE limit progression certainty.)",
  "timestamp": "2025-07-26T10:32:38.761353"
}