{
  "ptid_time": "129_S_4369_2011-11-17",
  "img_path": "/data/qiuhui/data/adni/images/129_S_4369/2011-11-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 12,712 mm³, 57.7% below the reference mean. With a Z-score of -1.37 (8.5th percentile), this represents mild atrophy; hippocampal volume measures 6,780 mm³, 15.5% below the reference mean. With a Z-score of -1.55 (6.0th percentile), this represents moderate atrophy; whole brain volume measures 1,032,990 mm³, 9.0% below the reference mean. With a Z-score of -1.27 (10.3th percentile), this represents mild atrophy; entorhinal cortex volume measures 4,077 mm³, 4.4% below the reference mean. With a Z-score of -0.30 (38.1th percentile), this represents normal volume ; fusiform gyrus volume measures 18,043 mm³, 9.4% below the reference mean. With a Z-score of -0.78 (21.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,223 mm³, 9.8% below the reference mean. With a Z-score of -0.80 (21.1th percentile), this represents normal volume . ",
  "text_data": "Age is 68.3 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Gastrointestinal; Malignancy; Major Surgical Procedures. MMSE: 29.0. MoCA: 24.0. Logical Memory: 13.0. Laboratory findings: Monocytes: 0.78 (profound elevated); MCH: 34.00 (significant elevated); MCHC: 36.00 (significant elevated); Hematocrit: 49.00 (significant elevated); Hemoglobin: 17.70 (profound elevated); WBC: 9.42 (significant elevated); Lymphocytes: 2.82 (significant elevated); GGT: 49.00 (profound elevated); ALT (SGPT): 36.00 (significant elevated); AST (SGOT): 39.00 (profound elevated); Phosphorus: 2.60 (significant reduced). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.99 SUVR (normal ); Total tau: 269.00 pg/mL (normal ); Phosphorylated tau: 24.56 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mild to moderate atrophy in the hippocampus and ventricles, which are early markers of neurodegeneration, but other regions (entorhinal cortex, fusiform gyrus, middle temporal gyrus) are within normal ranges. Cognitive testing (MMSE 29, MoCA 24) suggests mild cognitive impairment (MCI), as the MoCA is borderline impaired, while biomarkers (tau, amyloid) are normal.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (due to conflicting MoCA/MMSE scores and normal biomarkers, but hippocampal atrophy supports MCI)",
  "timestamp": "2025-07-26T14:15:23.458694"
}