{
  "ptid_time": "126_S_2405_2013-10-15",
  "img_path": "/data/qiuhui/data/adni/images/126_S_2405/2013-10-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,535 mm³, 12.4% above the reference mean. With a Z-score of 0.28 (61.1th percentile), this represents normal volume ; hippocampal volume measures 6,690 mm³, 6.0% below the reference mean. With a Z-score of -0.55 (29.2th percentile), this represents normal volume ; whole brain volume measures 941,824 mm³, 3.4% below the reference mean. With a Z-score of -0.42 (33.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,364 mm³, 8.4% below the reference mean. With a Z-score of -0.52 (30.3th percentile), this represents normal volume ; fusiform gyrus volume measures 19,818 mm³, 16.5% above the reference mean. With a Z-score of 1.50 (93.3th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 18,276 mm³, 4.7% below the reference mean. With a Z-score of -0.40 (34.3th percentile), this represents normal volume . ",
  "text_data": "Age is 73.6 years. Gender is Female. Education: 13 years. MMSE: 28.0. MoCA: 20.0. Logical Memory: 15.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.01 SUVR (normal ); Amyloid beta: 1689.00 pg/mL (moderate elevated); Total tau: 259.60 pg/mL (normal ); Phosphorylated tau: 22.85 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with only mild deviations (e.g., fusiform gyrus enlargement, slight hippocampal and entorhinal cortex reductions). The MMSE score (28/30) is normal, but the MoCA (20/30) suggests mild cognitive impairment. Biomarkers show moderately elevated Aβ (indicating amyloid pathology) but normal tau and AV45 (no significant neurodegeneration or amyloid PET positivity).  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (MoCA supports MCI, but structural changes are mild and biomarker profile is mixed—elevated Aβ without tauopathy suggests early-stage amyloid accumulation but not full dementia).",
  "timestamp": "2025-07-26T12:44:26.726181"
}