{
  "ptid_time": "027_S_2336_2013-05-02",
  "img_path": "/data/qiuhui/data/adni/images/027_S_2336/2013-05-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,612 mm³, 9.1% above the reference mean. With a Z-score of 0.21 (58.2th percentile), this represents normal volume ; hippocampal volume measures 6,706 mm³, 5.7% below the reference mean. With a Z-score of -0.53 (29.9th percentile), this represents normal volume ; whole brain volume measures 827,281 mm³, 15.1% below the reference mean. With a Z-score of -1.90 (2.8th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,376 mm³, 8.1% below the reference mean. With a Z-score of -0.50 (31.0th percentile), this represents normal volume ; fusiform gyrus volume measures 13,980 mm³, 17.8% below the reference mean. With a Z-score of -1.62 (5.2th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 14,758 mm³, 23.0% below the reference mean. With a Z-score of -2.00 (2.3th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 74.9 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Cardiovascular; Respiratory; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Smoking. MMSE: 28.0. MoCA: 25.0. Logical Memory: 5.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.53 SUVR (profound elevated); Amyloid beta: 857.80 pg/mL (normal ); Total tau: 337.80 pg/mL (mild elevated); Phosphorylated tau: 37.42 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows moderate atrophy in the whole brain, fusiform gyrus, and middle temporal gyrus, while hippocampal and entorhinal volumes are within normal limits. The biomarker profile (normal Aβ but elevated P-tau and AV45) suggests Alzheimer’s pathology despite the relatively preserved cognitive scores (MMSE 28, MoCA 25).  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology).  \n\n**Confidence:** **Medium** (cognitive scores are borderline normal, but biomarker and atrophy patterns strongly suggest early neurodegeneration).",
  "timestamp": "2025-07-26T03:55:56.500161"
}