{
  "ptid_time": "021_S_2150_2010-11-01",
  "img_path": "/data/qiuhui/data/adni/images/021_S_2150/2010-11-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 93,560 mm³, 142.9% above the reference mean. With a Z-score of 3.42 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 6,868 mm³, 9.1% below the reference mean. With a Z-score of -0.89 (18.6th percentile), this represents normal volume ; whole brain volume measures 1,294,960 mm³, 20.0% above the reference mean. With a Z-score of 2.59 (99.5th percentile), this represents significant enlargement; entorhinal cortex volume measures 4,414 mm³, 7.6% above the reference mean. With a Z-score of 0.52 (69.8th percentile), this represents normal volume ; fusiform gyrus volume measures 20,086 mm³, 6.6% above the reference mean. With a Z-score of 0.56 (71.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,622 mm³, 3.4% below the reference mean. With a Z-score of -0.30 (38.1th percentile), this represents normal volume . ",
  "text_data": "Age is 72.7 years. Gender is Male. Education: 14 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Gastrointestinal; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 26.0. MoCA: 24.0. Logical Memory: 7.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.31 SUVR (moderate elevated); Amyloid beta: 731.40 pg/mL (normal ); Total tau: 230.30 pg/mL (normal ); Phosphorylated tau: 24.90 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound ventricular enlargement (Z-score 3.42) and significant whole brain volume enlargement (Z-score 2.59), which could suggest atrophy or other structural changes. However, hippocampal volume is normal (Z-score -0.89), and CSF biomarkers (Aβ, T-tau, P-tau) are normal, despite moderate AV45 (amyloid PET) elevation. Cognitive scores (MMSE 26, MoCA 24) are borderline but not strongly indicative of dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging findings—ventricular enlargement vs. normal hippocampal volume—and borderline cognitive scores with normal CSF biomarkers but moderate amyloid PET elevation).",
  "timestamp": "2025-07-26T01:40:57.868066"
}