{
  "ptid_time": "068_S_2187_2010-11-15",
  "img_path": "/data/qiuhui/data/adni/images/068_S_2187/2010-11-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 14,784 mm³, 20.6% below the reference mean. With a Z-score of -0.59 (27.8th percentile), this represents normal volume ; hippocampal volume measures 8,395 mm³, 7.5% above the reference mean. With a Z-score of 1.05 (85.2th percentile), this represents mild enlargement; whole brain volume measures 1,276,420 mm³, 22.7% above the reference mean. With a Z-score of 2.72 (99.7th percentile), this represents significant enlargement; entorhinal cortex volume measures 3,429 mm³, 7.2% below the reference mean. With a Z-score of -0.56 (28.6th percentile), this represents normal volume ; fusiform gyrus volume measures 23,700 mm³, 28.6% above the reference mean. With a Z-score of 2.59 (99.5th percentile), this represents significant enlargement; middle temporal gyrus volume measures 25,951 mm³, 26.4% above the reference mean. With a Z-score of 2.18 (98.5th percentile), this represents significant enlargement. ",
  "text_data": "Age is 57.7 years. Gender is Female. Education: 13 years. Handedness: Right. Race: White. Medical history: Cardiovascular; Endocrine-Metabolic; Alcohol Abuse; Smoking; Major Surgical Procedures. MMSE: 29.0. MoCA: 24.0. Logical Memory: 8.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.05 SUVR (normal ); Total tau: 242.30 pg/mL (normal ); Phosphorylated tau: 21.21 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows significant enlargement in whole brain, fusiform gyrus, and middle temporal gyrus, with normal or mildly enlarged hippocampal and entorhinal cortex volumes. The MMSE is normal (29/30), but the MoCA (24/30) suggests mild cognitive impairment. Biomarkers (T-tau, P-tau, AV45) are normal, and APOE4 status is heterozygous (1 allele).  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (MoCA suggests MCI, but structural enlargement is atypical for neurodegeneration; biomarker normality reduces certainty of progression to dementia.)",
  "timestamp": "2025-07-26T08:54:33.639096"
}