{
  "ptid_time": "014_S_4615_2012-06-28",
  "img_path": "/data/qiuhui/data/adni/images/014_S_4615/2012-06-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 63,349 mm³, 34.7% above the reference mean. With a Z-score of 1.01 (84.4th percentile), this represents mild enlargement; hippocampal volume measures 5,399 mm³, 22.5% below the reference mean. With a Z-score of -1.95 (2.6th percentile), this represents moderate atrophy; whole brain volume measures 987,794 mm³, 4.0% below the reference mean. With a Z-score of -0.53 (29.9th percentile), this represents normal volume . ",
  "text_data": "Age is 86.5 years. Gender is Male. Education: 17 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 26.0. MoCA: 14.0. Logical Memory: 2.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.27 SUVR (mild elevated); Amyloid beta: 864.50 pg/mL (normal ); Total tau: 303.50 pg/mL (normal ); Phosphorylated tau: 30.62 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate hippocampal atrophy (Z-score -1.95, 2.6th percentile) and mild ventricular enlargement, alongside a low MoCA score (14/30) despite a near-normal MMSE (26/30). Biomarkers indicate mild amyloid deposition (AV45 elevated) and mildly elevated p-tau, but normal Aβ and t-tau. These findings suggest cognitive impairment beyond normal aging, likely due to underlying neurodegenerative pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype given hippocampal atrophy and MoCA deficits).  \n\n**Confidence:** **Medium** (biomarkers are not strongly AD-like, but hippocampal atrophy and cognitive deficits support MCI; age and APOE4-negative status reduce certainty for AD progression).",
  "timestamp": "2025-07-25T23:57:09.557228"
}