{
  "ptid_time": "021_S_5236_2013-06-27",
  "img_path": "/data/qiuhui/data/adni/images/021_S_5236/2013-06-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 28,058 mm³, 40.3% below the reference mean. With a Z-score of -1.17 (12.1th percentile), this represents mild atrophy; hippocampal volume measures 7,400 mm³, 6.2% above the reference mean. With a Z-score of 0.54 (70.4th percentile), this represents normal volume ; whole brain volume measures 1,102,000 mm³, 7.1% above the reference mean. With a Z-score of 0.93 (82.3th percentile), this represents normal volume ; entorhinal cortex volume measures 3,143 mm³, 20.8% below the reference mean. With a Z-score of -1.36 (8.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 21,239 mm³, 17.6% above the reference mean. With a Z-score of 1.52 (93.6th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 21,383 mm³, 6.0% above the reference mean. With a Z-score of 0.54 (70.5th percentile), this represents normal volume . ",
  "text_data": "Age is 85.3 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 28.0. MoCA: 24.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.09 SUVR (normal ); Amyloid beta: 1141.00 pg/mL (normal ); Total tau: 427.30 pg/mL (significant elevated); Phosphorylated tau: 40.99 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild atrophy in the ventricular volume and entorhinal cortex, but hippocampal and whole brain volumes are normal. Elevated T-tau and P-tau with normal Aβ and AV45 suggest non-Alzheimer's pathology (e.g., primary age-related tauopathy or PART). Cognitive scores (MMSE 28, MoCA 24) are borderline for MCI but not dementia.  \n\n**Diagnosis:** **MCI** (mild cognitive impairment)  \n**Confidence:** **Medium** (due to conflicting biomarkers and borderline cognitive scores)",
  "timestamp": "2025-07-26T01:55:17.616182"
}