{
  "ptid_time": "035_S_4785_2013-06-06",
  "img_path": "/data/qiuhui/data/adni/images/035_S_4785/2013-06-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 21,075 mm³, 5.6% below the reference mean. With a Z-score of -0.14 (44.4th percentile), this represents normal volume ; hippocampal volume measures 6,895 mm³, 10.3% below the reference mean. With a Z-score of -1.15 (12.4th percentile), this represents mild atrophy; whole brain volume measures 1,046,240 mm³, 1.7% above the reference mean. With a Z-score of 0.21 (58.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,444 mm³, 11.5% below the reference mean. With a Z-score of -0.89 (18.6th percentile), this represents normal volume ; fusiform gyrus volume measures 17,241 mm³, 5.3% below the reference mean. With a Z-score of -0.60 (27.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,617 mm³, 5.3% above the reference mean. With a Z-score of 0.48 (68.3th percentile), this represents normal volume . ",
  "text_data": "Age is 66.7 years. Gender is Female. Education: 13 years. Handedness: Right. Race: White. Medical history: Neurologic; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. MoCA: 25.0. Logical Memory: 13.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.99 SUVR (normal ); Amyloid beta: 1661.00 pg/mL (moderate elevated); Total tau: 168.10 pg/mL (normal ); Phosphorylated tau: 14.04 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.15, 12.4th percentile), which is concerning for early neurodegeneration, while other brain volumes are within normal ranges. The MMSE is normal (29/30), but the MoCA (25/30) suggests mild cognitive impairment (MCI). Biomarkers show moderately elevated Aβ (suggestive of amyloid pathology) but normal tau and AV45.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to hippocampal atrophy and borderline MoCA, but lack of significant functional decline or widespread atrophy)",
  "timestamp": "2025-07-26T05:59:05.078864"
}