{
  "ptid_time": "021_S_4402_2011-12-14",
  "img_path": "/data/qiuhui/data/adni/images/021_S_4402/2011-12-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,881 mm³, 17.1% above the reference mean. With a Z-score of 0.39 (65.3th percentile), this represents normal volume ; hippocampal volume measures 5,865 mm³, 17.6% below the reference mean. With a Z-score of -1.61 (5.4th percentile), this represents moderate atrophy; whole brain volume measures 997,942 mm³, 2.4% above the reference mean. With a Z-score of 0.30 (61.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,929 mm³, 20.3% below the reference mean. With a Z-score of -1.24 (10.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 14,891 mm³, 12.5% below the reference mean. With a Z-score of -1.14 (12.8th percentile), this represents mild atrophy; middle temporal gyrus volume measures 18,189 mm³, 5.1% below the reference mean. With a Z-score of -0.44 (32.9th percentile), this represents normal volume . ",
  "text_data": "Age is 72.9 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Cardiovascular; Respiratory; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 25.0. MoCA: 21.0. Logical Memory: 1.0. Laboratory findings: Monocytes: 0.73 (profound elevated); Basophils: 0.14 (profound elevated); Basophils: 1.50 (significant elevated); WBC: 9.23 (significant elevated). APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.62 SUVR (profound elevated); Amyloid beta: 456.80 pg/mL (mild reduced); Total tau: 479.50 pg/mL (profound elevated); Phosphorylated tau: 46.42 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows moderate hippocampal atrophy and mild atrophy in the entorhinal cortex and fusiform gyrus, which are key regions affected in Alzheimer's disease. The CSF biomarkers (elevated T-tau, P-tau, and AV45 with mildly reduced Aβ) strongly support Alzheimer's pathology, while the cognitive scores (MMSE 25, MoCA 21) indicate mild cognitive impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI) due to Alzheimer’s disease**  \n**Confidence:** **High**  \n\n*(Note: The diagnosis is MCI rather than dementia because, despite biomarker evidence of Alzheimer’s pathology, the cognitive deficits are not severe enough to significantly impair daily functioning, which is required for a dementia diagnosis.)*",
  "timestamp": "2025-07-26T01:46:59.864224"
}