{
  "ptid_time": "014_S_4263_2011-10-06",
  "img_path": "/data/qiuhui/data/adni/images/014_S_4263/2011-10-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 65,865 mm³, 71.0% above the reference mean. With a Z-score of 1.70 (95.6th percentile), this represents moderate enlargement; hippocampal volume measures 6,622 mm³, 12.4% below the reference mean. With a Z-score of -1.21 (11.3th percentile), this represents mild atrophy; whole brain volume measures 1,137,160 mm³, 5.4% above the reference mean. With a Z-score of 0.69 (75.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,875 mm³, 5.5% below the reference mean. With a Z-score of -0.37 (35.5th percentile), this represents normal volume ; fusiform gyrus volume measures 24,978 mm³, 32.6% above the reference mean. With a Z-score of 2.78 (99.7th percentile), this represents significant enlargement; middle temporal gyrus volume measures 25,611 mm³, 20.0% above the reference mean. With a Z-score of 1.80 (96.4th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 74.3 years. Gender is Male. Education: 20 years. Handedness: Left. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Renal-Genitourinary; Smoking; Major Surgical Procedures. MMSE: 27.0. MoCA: 21.0. Logical Memory: 2.0. Laboratory findings: Total Bilirubin: 0.90 (significant elevated). APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.88 SUVR (profound elevated); Amyloid beta: 669.30 pg/mL (normal ); Total tau: 404.30 pg/mL (significant elevated); Phosphorylated tau: 41.11 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate ventricular enlargement and mild hippocampal atrophy, both suggestive of neurodegeneration. Elevated T-tau and P-tau with profound AV45 (amyloid) positivity indicate Alzheimer’s pathology, despite normal Aβ levels (possible discordance or assay-specific result). The MMSE (27) is near-normal, but the MoCA (21) suggests cognitive impairment, aligning with MCI.  \n\n**Diagnosis:** **MCI (likely due to Alzheimer’s disease)**  \n**Confidence:** **High**  \n\n*(Note: The Aβ \"normal\" result is atypical for AD but could reflect assay variability or a non-amyloid tauopathy; however, elevated AV45 (PET amyloid) strongly supports AD pathology. The tau elevation and imaging findings reinforce this.)*",
  "timestamp": "2025-07-25T23:52:59.878741"
}