{
  "ptid_time": "007_S_2058_2010-09-02",
  "img_path": "/data/qiuhui/data/adni/images/007_S_2058/2010-09-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 84,471 mm³, 128.5% above the reference mean. With a Z-score of 3.47 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,973 mm³, 8.0% below the reference mean. With a Z-score of -0.64 (26.0th percentile), this represents normal volume ; whole brain volume measures 1,005,780 mm³, 8.4% above the reference mean. With a Z-score of 1.00 (84.2th percentile), this represents mild enlargement; entorhinal cortex volume measures 2,435 mm³, 29.7% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 15,650 mm³, 2.9% below the reference mean. With a Z-score of -0.21 (41.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,259 mm³, 23.5% above the reference mean. With a Z-score of 2.09 (98.2th percentile), this represents significant enlargement. ",
  "text_data": "Age is 83.9 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Major Surgical Procedures. MMSE: 27.0. MoCA: 24.0. Logical Memory: 6.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 0.87 SUVR (moderate reduced); Amyloid beta: 1552.00 pg/mL (mild elevated); Total tau: 422.20 pg/mL (significant elevated); Phosphorylated tau: 37.61 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 3.47) and moderate entorhinal cortex atrophy (Z-score -1.60), both indicative of neurodegeneration. Elevated Aβ, T-tau, and P-tau, along with reduced AV45, strongly suggest Alzheimer’s pathology. Despite relatively preserved hippocampal volume and normal MMSE/MoCA scores, the biomarker profile and structural changes point to early dementia.  \n\n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** Medium (clinical scores are borderline, but biomarkers and structural changes are compelling)",
  "timestamp": "2025-07-25T21:55:49.486819"
}