{
  "ptid_time": "153_S_4151_2011-08-18",
  "img_path": "/data/qiuhui/data/adni/images/153_S_4151/2011-08-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,611 mm³, 46.5% below the reference mean. With a Z-score of -1.11 (13.3th percentile), this represents mild atrophy; hippocampal volume measures 7,062 mm³, 6.6% below the reference mean. With a Z-score of -0.64 (26.1th percentile), this represents normal volume ; whole brain volume measures 867,484 mm³, 19.6% below the reference mean. With a Z-score of -2.55 (0.5th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,932 mm³, 4.1% below the reference mean. With a Z-score of -0.28 (39.0th percentile), this represents normal volume ; fusiform gyrus volume measures 11,990 mm³, 36.4% below the reference mean. With a Z-score of -3.10 (0.1th percentile), this represents profound atrophy; middle temporal gyrus volume measures 17,540 mm³, 17.8% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 72.2 years. Gender is Male. Education: 14 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Respiratory; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 29.0. MoCA: 27.0. Logical Memory: 11.0. Laboratory findings: Basophils: 0.10 (significant elevated); Hematocrit: 53.00 (profound elevated); RBC: 5.60 (significant elevated); Hemoglobin: 17.30 (significant elevated); Creatine Kinase: 315.00 (profound elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.35 SUVR (significant elevated); Amyloid beta: 492.70 pg/mL (mild reduced); Total tau: 189.60 pg/mL (normal ); Phosphorylated tau: 17.85 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in whole brain volume and profound atrophy in the fusiform gyrus, with mild-to-moderate atrophy in other regions (ventricular, middle temporal gyrus). However, hippocampal and entorhinal cortex volumes are within normal limits. Clinically, cognitive scores (MMSE 29, MoCA 27) are intact, and CSF biomarkers (normal T-tau, P-tau) do not strongly support Alzheimer’s pathology despite elevated AV45 (amyloid PET) and mildly reduced Aβ.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural atrophy is concerning, but preserved cognition and mixed biomarker findings complicate a definitive dementia diagnosis at this stage.)",
  "timestamp": "2025-07-26T17:12:11.097435"
}