{
  "ptid_time": "137_S_4211_2011-12-13",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4211/2011-12-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,024 mm³, 18.8% below the reference mean. With a Z-score of -0.51 (30.6th percentile), this represents normal volume ; hippocampal volume measures 4,981 mm³, 23.3% below the reference mean. With a Z-score of -1.87 (3.1th percentile), this represents moderate atrophy; whole brain volume measures 851,396 mm³, 8.3% below the reference mean. With a Z-score of -0.99 (16.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,271 mm³, 5.5% below the reference mean. With a Z-score of -0.30 (38.3th percentile), this represents normal volume ; fusiform gyrus volume measures 16,476 mm³, 2.3% above the reference mean. With a Z-score of 0.17 (56.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,135 mm³, 10.5% below the reference mean. With a Z-score of -0.93 (17.5th percentile), this represents normal volume . ",
  "text_data": "Age is 80.9 years. Gender is Female. Education: 15 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 22.0. MoCA: 15.0. Logical Memory: 4.0. Laboratory findings: Vitamin B12: 1169.00 (profound elevated); Platelets: 389.00 (significant elevated); Total Protein: 8.00 (significant elevated); Calcium (EDTA): 10.70 (significant elevated); Cholesterol (High Performance): 307.00 (profound elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.40 SUVR (significant elevated); Amyloid beta: 456.00 pg/mL (mild reduced); Total tau: 211.60 pg/mL (normal ); Phosphorylated tau: 20.36 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.87, 3.1th percentile), which is a strong biomarker for Alzheimer's disease (AD). The MMSE (22) and MoCA (15) scores indicate cognitive impairment, and the elevated AV45 (amyloid PET) with mildly reduced Aβ (CSF) suggests amyloid pathology. However, normal T-tau and P-tau levels reduce the certainty of AD progression.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology, given hippocampal atrophy and amyloid positivity, but not yet meeting full dementia criteria).  \n\n**Confidence:** **Medium** (due to conflicting biomarkers—hippocampal atrophy and amyloid elevation support AD, but normal tau and only mild cognitive deficits suggest MCI rather than full dementia).",
  "timestamp": "2025-07-26T16:28:14.861408"
}