{
  "ptid_time": "002_S_5230_2013-06-27",
  "img_path": "/data/qiuhui/data/adni/images/002_S_5230/2013-06-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 63,361 mm³, 125.7% above the reference mean. With a Z-score of 2.88 (99.8th percentile), this represents significant enlargement; hippocampal volume measures 7,685 mm³, 8.0% above the reference mean. With a Z-score of 0.74 (76.9th percentile), this represents normal volume ; whole brain volume measures 980,565 mm³, 0.6% above the reference mean. With a Z-score of 0.08 (53.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,537 mm³, 3.7% below the reference mean. With a Z-score of -0.23 (41.0th percentile), this represents normal volume ; fusiform gyrus volume measures 16,486 mm³, 3.1% below the reference mean. With a Z-score of -0.28 (38.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,327 mm³, 0.8% above the reference mean. With a Z-score of 0.07 (52.8th percentile), this represents normal volume . ",
  "text_data": "Age is 73.5 years. Gender is Female. Education: 19 years. Handedness: Left. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Hepatic; Musculoskeletal; Hematopoietic-Lymphatic; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 29.0. MoCA: 24.0. Logical Memory: 13.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.55 SUVR (profound elevated); Amyloid beta: 1006.00 pg/mL (normal ); Total tau: 253.00 pg/mL (normal ); Phosphorylated tau: 22.84 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.88), which is a marker of brain atrophy, but other key regions (hippocampus, whole brain, entorhinal cortex, fusiform gyrus, middle temporal gyrus) are within normal ranges. Cognitive testing (MMSE 29, MoCA 24) suggests mild cognitive concerns, but CSF biomarkers (Aβ, T-tau, P-tau) are normal despite elevated AV45 (amyloid PET), which is conflicting.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting amyloid imaging and CSF results, but cognitive scores and ventricular enlargement suggest early decline)",
  "timestamp": "2025-07-25T20:33:55.511851"
}