{
  "ptid_time": "041_S_5097_2013-05-29",
  "img_path": "/data/qiuhui/data/adni/images/041_S_5097/2013-05-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,918 mm³, 23.0% above the reference mean. With a Z-score of 0.55 (70.7th percentile), this represents normal volume ; hippocampal volume measures 6,231 mm³, 22.4% below the reference mean. With a Z-score of -2.24 (1.3th percentile), this represents significant atrophy; whole brain volume measures 979,372 mm³, 13.7% below the reference mean. With a Z-score of -1.94 (2.6th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,421 mm³, 19.7% below the reference mean. With a Z-score of -1.37 (8.6th percentile), this represents mild atrophy; fusiform gyrus volume measures 13,595 mm³, 31.7% below the reference mean. With a Z-score of -2.64 (0.4th percentile), this represents significant atrophy; middle temporal gyrus volume measures 16,708 mm³, 25.4% below the reference mean. With a Z-score of -2.10 (1.8th percentile), this represents significant atrophy. ",
  "text_data": "Age is 67.5 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Alcohol Abuse; Smoking; Malignancy; Major Surgical Procedures. MMSE: 27.0. MoCA: 22.0. Logical Memory: 9.0. Laboratory findings: MCH: 21.00 (profound reduced); MCHC: 30.00 (significant reduced); Basophils: 0.11 (significant elevated); Basophils: 2.10 (profound elevated); Hematocrit: 33.00 (significant reduced); Hemoglobin: 9.90 (profound reduced). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.11 SUVR (normal ); Amyloid beta: 1328.00 pg/mL (normal ); Total tau: 204.50 pg/mL (normal ); Phosphorylated tau: 16.48 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the hippocampus, fusiform gyrus, and middle temporal gyrus—key regions affected in Alzheimer's disease—while CSF biomarkers (Aβ, T-tau, P-tau) and amyloid PET (AV45) are normal. The cognitive scores (MMSE 27, MoCA 22) suggest mild impairment, but the lack of biomarker evidence for amyloid or tau pathology makes typical AD less likely.  \n**Diagnosis:** **MCI** (likely non-amyloid subtype, e.g., hippocampal sclerosis or primary age-related tauopathy)  \n**Confidence:** **Medium** (due to discordance between structural atrophy and biomarker profiles).  \n\n*Note: A non-AD neurodegenerative process (e.g., LATE-NC) should also be considered given the hippocampal-predominant atrophy with normal AD biomarkers.*",
  "timestamp": "2025-07-26T07:25:06.671907"
}