{
  "ptid_time": "073_S_4614_2014-04-17",
  "img_path": "/data/qiuhui/data/adni/images/073_S_4614/2014-04-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,024 mm³, 10.4% below the reference mean. With a Z-score of -0.26 (39.8th percentile), this represents normal volume ; hippocampal volume measures 6,677 mm³, 13.1% below the reference mean. With a Z-score of -1.47 (7.1th percentile), this represents mild atrophy; whole brain volume measures 950,405 mm³, 7.7% below the reference mean. With a Z-score of -0.95 (17.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,314 mm³, 14.9% below the reference mean. With a Z-score of -1.15 (12.5th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,326 mm³, 10.3% below the reference mean. With a Z-score of -1.17 (12.2th percentile), this represents mild atrophy; middle temporal gyrus volume measures 19,338 mm³, 5.8% below the reference mean. With a Z-score of -0.51 (30.4th percentile), this represents normal volume . ",
  "text_data": "Age is 69.7 years. Gender is Female. Education: 20 years. MMSE: 23.0. MoCA: 26.0. Logical Memory: 17.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.13 SUVR (normal ); Amyloid beta: 1396.00 pg/mL (normal ); Total tau: 340.90 pg/mL (mild elevated); Phosphorylated tau: 33.53 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild atrophy in the hippocampus, entorhinal cortex, and fusiform gyrus—regions critical for memory and cognition—while ventricular and whole brain volumes are normal. Cognitive testing (MMSE 23, MoCA 26) suggests mild impairment, and CSF biomarkers (elevated T-tau and P-tau with normal Aβ) are consistent with Alzheimer's pathology despite normal amyloid PET (AV45).  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's disease given biomarker profile).  \n\n**Confidence:** **Medium** (cognitive scores are borderline, and amyloid PET-normal CSF Aβ discordance introduces some uncertainty).",
  "timestamp": "2025-07-26T09:50:42.668547"
}