{
  "ptid_time": "029_S_5219_2013-09-25",
  "img_path": "/data/qiuhui/data/adni/images/029_S_5219/2013-09-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 13,282 mm³, 65.5% below the reference mean. With a Z-score of -1.57 (5.8th percentile), this represents moderate atrophy; hippocampal volume measures 7,285 mm³, 3.6% below the reference mean. With a Z-score of -0.35 (36.2th percentile), this represents normal volume ; whole brain volume measures 1,137,890 mm³, 5.4% above the reference mean. With a Z-score of 0.70 (75.9th percentile), this represents normal volume ; entorhinal cortex volume measures 4,310 mm³, 5.1% above the reference mean. With a Z-score of 0.35 (63.5th percentile), this represents normal volume ; fusiform gyrus volume measures 19,442 mm³, 3.2% above the reference mean. With a Z-score of 0.27 (60.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,738 mm³, 6.6% above the reference mean. With a Z-score of 0.59 (72.2th percentile), this represents normal volume . ",
  "text_data": "Age is 75.7 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Renal-Genitourinary; Smoking; Malignancy. MMSE: 24.0. MoCA: 19.0. Logical Memory: 12.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.02 SUVR (normal ); Amyloid beta: 1145.00 pg/mL (normal ); Total tau: 343.30 pg/mL (mild elevated); Phosphorylated tau: 28.83 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate ventricular atrophy (Z-score -1.57) but otherwise normal brain volumes, including the hippocampus. Cognitive testing (MMSE 24, MoCA 19) suggests mild impairment, while biomarkers (normal Aβ, mild T-tau elevation, normal P-tau, normal AV45) do not strongly support Alzheimer’s pathology.  \n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (due to cognitive decline without clear biomarker evidence of AD)",
  "timestamp": "2025-07-26T04:33:09.164847"
}