{
  "ptid_time": "019_S_4367_2011-11-30",
  "img_path": "/data/qiuhui/data/adni/images/019_S_4367/2011-11-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 14,244 mm³, 36.2% below the reference mean. With a Z-score of -0.91 (18.2th percentile), this represents normal volume ; hippocampal volume measures 7,659 mm³, 0.3% below the reference mean. With a Z-score of -0.04 (48.5th percentile), this represents normal volume ; whole brain volume measures 1,108,150 mm³, 7.7% above the reference mean. With a Z-score of 0.96 (83.0th percentile), this represents normal volume ; entorhinal cortex volume measures 4,340 mm³, 11.5% above the reference mean. With a Z-score of 0.89 (81.3th percentile), this represents normal volume ; fusiform gyrus volume measures 17,777 mm³, 2.4% below the reference mean. With a Z-score of -0.27 (39.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,278 mm³, 10.9% below the reference mean. With a Z-score of -0.97 (16.6th percentile), this represents normal volume . ",
  "text_data": "Age is 65.1 years. Gender is Female. Education: 18 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Smoking; Major Surgical Procedures. MMSE: 29.0. MoCA: 22.0. Logical Memory: 12.0. Laboratory findings: Creatine Kinase: 236.00 (significant elevated); Alkaline Phosphatase: 134.00 (profound elevated); GGT: 39.00 (significant elevated). APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.01 SUVR (normal ); Amyloid beta: 938.80 pg/mL (normal ); Total tau: 213.00 pg/mL (normal ); Phosphorylated tau: 20.11 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volumes (hippocampus, entorhinal cortex, fusiform gyrus, etc.) are within normal ranges, and biomarkers (Aβ, T-tau, P-tau, AV45) are normal. However, the MoCA score (22/30) suggests mild cognitive impairment, while the MMSE (29/30) is near-normal, indicating possible early cognitive decline.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (due to discrepancy between MoCA and MMSE, but normal biomarkers and brain volumes suggest non-Alzheimer’s etiology)",
  "timestamp": "2025-07-26T01:04:50.172385"
}