{
  "ptid_time": "005_S_4168_2011-11-30",
  "img_path": "/data/qiuhui/data/adni/images/005_S_4168/2011-11-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,419 mm³, 28.9% below the reference mean. With a Z-score of -0.84 (20.0th percentile), this represents normal volume ; hippocampal volume measures 7,532 mm³, 8.1% above the reference mean. With a Z-score of 0.70 (75.8th percentile), this represents normal volume ; whole brain volume measures 1,082,490 mm³, 5.2% above the reference mean. With a Z-score of 0.68 (75.1th percentile), this represents normal volume ; entorhinal cortex volume measures 5,322 mm³, 34.1% above the reference mean. With a Z-score of 2.23 (98.7th percentile), this represents significant enlargement; fusiform gyrus volume measures 17,948 mm³, 0.7% below the reference mean. With a Z-score of -0.06 (47.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,255 mm³, 0.4% above the reference mean. With a Z-score of 0.04 (51.5th percentile), this represents normal volume . ",
  "text_data": "Age is 82.2 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; Gastrointestinal; Hematopoietic-Lymphatic; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. MoCA: 24.0. Logical Memory: 9.0. Laboratory findings: . APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.08 SUVR (normal ); Amyloid beta: 723.40 pg/mL (normal ); Total tau: 240.50 pg/mL (normal ); Phosphorylated tau: 21.10 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with the entorhinal cortex showing significant enlargement (Z-score 2.23, 98.7th percentile), which is atypical for Alzheimer’s but not necessarily pathological. Cognitive scores (MMSE 29, MoCA 24) are borderline for MCI (MoCA <26 suggests possible impairment), but biomarkers (Aβ, tau, AV45) are normal, reducing likelihood of Alzheimer’s pathology.  \n\n**Diagnosis:** **MCI** (due to MoCA score suggesting mild cognitive concern, but no biomarker or structural evidence of neurodegeneration).  \n\n**Confidence:** **Medium** (MoCA is slightly concerning, but normal biomarkers and preserved brain volumes contradict typical Alzheimer’s progression).",
  "timestamp": "2025-07-25T21:19:42.651668"
}