{
  "ptid_time": "024_S_4158_2013-08-29",
  "img_path": "/data/qiuhui/data/adni/images/024_S_4158/2013-08-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,026 mm³, 17.0% below the reference mean. With a Z-score of -0.49 (31.1th percentile), this represents normal volume ; hippocampal volume measures 6,042 mm³, 13.3% below the reference mean. With a Z-score of -1.15 (12.5th percentile), this represents mild atrophy; whole brain volume measures 947,333 mm³, 8.0% below the reference mean. With a Z-score of -1.04 (14.9th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,360 mm³, 15.3% below the reference mean. With a Z-score of -1.00 (15.8th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,796 mm³, 7.0% below the reference mean. With a Z-score of -0.61 (27.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,558 mm³, 17.9% below the reference mean. With a Z-score of -1.61 (5.4th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 86.3 years. Gender is Male. Education: 18 years. MMSE: 30.0. MoCA: 28.0. Logical Memory: 19.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.98 SUVR (normal ); Amyloid beta: 1661.00 pg/mL (moderate elevated); Total tau: 208.10 pg/mL (normal ); Phosphorylated tau: 17.39 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "Reasoning: The patient shows mild to moderate atrophy in key regions associated with Alzheimer's disease (hippocampus, whole brain, entorhinal cortex, and middle temporal gyrus), alongside normal ventricular and fusiform gyrus volumes. Despite normal cognitive scores (MMSE 30, MoCA 28), moderate Aβ elevation suggests amyloid pathology, though tau markers are normal.  \nDiagnosis: **Mild Cognitive Impairment (MCI)**  \nConfidence: **Medium** (Atrophy and Aβ elevation raise concern, but preserved cognition and normal tau complicate a dementia diagnosis.)",
  "timestamp": "2025-07-26T03:18:35.857715"
}