{
  "ptid_time": "002_S_4262_2011-10-05",
  "img_path": "/data/qiuhui/data/adni/images/002_S_4262/2011-10-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 61,364 mm³, 118.6% above the reference mean. With a Z-score of 2.72 (99.7th percentile), this represents significant enlargement; hippocampal volume measures 7,135 mm³, 0.3% above the reference mean. With a Z-score of 0.03 (51.1th percentile), this represents normal volume ; whole brain volume measures 969,297 mm³, 0.5% below the reference mean. With a Z-score of -0.07 (47.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,738 mm³, 1.8% above the reference mean. With a Z-score of 0.11 (54.3th percentile), this represents normal volume ; fusiform gyrus volume measures 16,215 mm³, 4.7% below the reference mean. With a Z-score of -0.43 (33.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,776 mm³, 8.4% above the reference mean. With a Z-score of 0.73 (76.7th percentile), this represents normal volume . ",
  "text_data": "Age is 72.8 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Gastrointestinal; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. MoCA: 27.0. Logical Memory: 12.0. Laboratory findings: Total Bilirubin: 0.90 (significant elevated); Phosphorus: 2.60 (significant reduced). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.54 SUVR (profound elevated); Amyloid beta: 790.50 pg/mL (normal ); Total tau: 347.90 pg/mL (mild elevated); Phosphorylated tau: 34.28 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.72), which is a marker of brain atrophy, but other key regions (hippocampus, entorhinal cortex, whole brain) are within normal ranges. Biomarkers indicate elevated tau (both T-tau and P-tau) and profound Aβ deposition (AV45), suggesting Alzheimer's pathology, but cognitive scores (MMSE 29, MoCA 27) remain intact.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to biomarker evidence of AD pathology despite preserved cognition).  \n**Confidence:** **Medium** (cognitive scores are high, but biomarker and ventricular enlargement strongly suggest early neurodegeneration).",
  "timestamp": "2025-07-25T20:25:45.150648"
}