{
  "ptid_time": "011_S_4105_2013-07-26",
  "img_path": "/data/qiuhui/data/adni/images/011_S_4105/2013-07-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 57,309 mm³, 104.2% above the reference mean. With a Z-score of 2.39 (99.1th percentile), this represents significant enlargement; whole brain volume measures 998,679 mm³, 2.5% above the reference mean. With a Z-score of 0.31 (62.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,265 mm³, 11.1% below the reference mean. With a Z-score of -0.68 (24.8th percentile), this represents normal volume ; fusiform gyrus volume measures 15,041 mm³, 11.6% below the reference mean. With a Z-score of -1.05 (14.6th percentile), this represents mild atrophy; middle temporal gyrus volume measures 18,920 mm³, 1.3% below the reference mean. With a Z-score of -0.11 (45.5th percentile), this represents normal volume . ",
  "text_data": "Age is 72.8 years. Gender is Female. Education: 18 years. MMSE: 30.0. MoCA: 23.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.05 SUVR (normal ); Amyloid beta: 1258.00 pg/mL (normal ); Total tau: 143.60 pg/mL (mild reduced); Phosphorylated tau: 12.23 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.39), which is often associated with neurodegeneration, alongside mild atrophy in the fusiform gyrus (Z-score -1.05). However, whole brain volume and most regional volumes (entorhinal cortex, middle temporal gyrus) are within normal ranges. Cognitive testing reveals a normal MMSE (30) but borderline MoCA (23), suggesting possible mild cognitive impairment (MCI). Biomarkers (Aβ normal, T-tau/P-tau mildly reduced, AV45 normal) do not strongly support Alzheimer’s pathology.  \n\n**Diagnosis:** **MCI** (mild cognitive impairment)  \n**Confidence:** **Medium** (due to mixed imaging findings and borderline MoCA, but lack of clear biomarker evidence for dementia)",
  "timestamp": "2025-07-25T22:53:52.532554"
}