{
  "ptid_time": "126_S_4675_2012-07-27",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4675/2012-07-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 48,607 mm³, 26.2% above the reference mean. With a Z-score of 0.63 (73.5th percentile), this represents normal volume ; hippocampal volume measures 5,922 mm³, 21.7% below the reference mean. With a Z-score of -2.11 (1.7th percentile), this represents significant atrophy; whole brain volume measures 983,305 mm³, 8.9% below the reference mean. With a Z-score of -1.16 (12.4th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,535 mm³, 13.8% below the reference mean. With a Z-score of -0.94 (17.5th percentile), this represents normal volume ; fusiform gyrus volume measures 16,251 mm³, 13.7% below the reference mean. With a Z-score of -1.17 (12.1th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,923 mm³, 20.7% below the reference mean. With a Z-score of -1.86 (3.1th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 79.8 years. Gender is Male. Education: 12 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Smoking; Malignancy; Major Surgical Procedures. MMSE: 25.0. MoCA: 20.0. Logical Memory: 4.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.64 SUVR (profound elevated); Amyloid beta: 733.70 pg/mL (normal ); Total tau: 514.20 pg/mL (profound elevated); Phosphorylated tau: 52.77 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient exhibits significant hippocampal atrophy (Z-score -2.11, 1.7th percentile) and moderate atrophy in the middle temporal gyrus (Z-score -1.86, 3.1st percentile), alongside mild whole brain and fusiform gyrus atrophy. Despite normal Aβ levels, profound elevations in T-tau, P-tau, and AV45 suggest underlying neurodegenerative pathology. Cognitive scores (MMSE 25, MoCA 20) indicate mild impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology given biomarker profile).  \n\n**Confidence:** **High** (due to clear structural atrophy in memory-related regions, biomarker evidence of neurodegeneration, and cognitive scores consistent with MCI).  \n\n*Note: Progression to dementia is likely given the biomarker and atrophy profile, but current cognitive deficits do not yet meet dementia criteria.*",
  "timestamp": "2025-07-26T12:48:29.786403"
}