{
  "ptid_time": "123_S_4806_2012-09-21",
  "img_path": "/data/qiuhui/data/adni/images/123_S_4806/2012-09-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,775 mm³, 59.0% above the reference mean. With a Z-score of 0.78 (78.3th percentile), this represents normal volume ; hippocampal volume measures 7,076 mm³.; whole brain volume measures 1,089,030 mm³, 8.6% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,986 mm³, 0.4% below the reference mean. With a Z-score of -0.04 (48.5th percentile), this represents normal volume ; fusiform gyrus volume measures 19,092 mm³, 8.4% below the reference mean. With a Z-score of -1.28 (10.1th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,167 mm³.. ",
  "text_data": "Age is 55.9 years. Gender is Male. Education: 19 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Renal-Genitourinary; Major Surgical Procedures. MMSE: 30.0. MoCA: 24.0. Logical Memory: 5.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.04 SUVR (normal ); Amyloid beta: 927.50 pg/mL (normal ); Total tau: 106.30 pg/mL (moderate reduced); Phosphorylated tau: 8.87 pg/mL (moderate reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate whole brain atrophy (Z-score -1.60) and mild fusiform gyrus atrophy (Z-score -1.28), but hippocampal and entorhinal cortex volumes are normal. Cognitive testing reveals a normal MMSE but a borderline MoCA (24/30), suggesting possible subtle cognitive deficits. Biomarkers (Aβ normal, reduced T-tau/P-tau) do not strongly support Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging and biomarker findings, but MoCA suggests cognitive decline beyond normal aging)",
  "timestamp": "2025-07-26T12:34:14.002354"
}