{
  "ptid_time": "041_S_4271_2011-10-07",
  "img_path": "/data/qiuhui/data/adni/images/041_S_4271/2011-10-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 24,652 mm³, 17.9% below the reference mean. With a Z-score of -0.43 (33.5th percentile), this represents normal volume ; hippocampal volume measures 4,695 mm³, 41.5% below the reference mean. With a Z-score of -4.15 (0.0th percentile), this represents profound atrophy; whole brain volume measures 968,216 mm³, 14.7% below the reference mean. With a Z-score of -2.07 (1.9th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,098 mm³, 50.8% below the reference mean. With a Z-score of -3.51 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 16,377 mm³, 17.7% below the reference mean. With a Z-score of -1.47 (7.0th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,647 mm³, 25.7% below the reference mean. With a Z-score of -2.12 (1.7th percentile), this represents significant atrophy. ",
  "text_data": "Age is 61.8 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Endocrine-Metabolic; Major Surgical Procedures. MMSE: 30.0. MoCA: 24.0. Logical Memory: 9.0. Laboratory findings: Hematocrit: 50.00 (significant elevated); Hemoglobin: 17.00 (significant elevated); Serum Glucose: 70.00 (significant reduced); AST (SGOT): 34.00 (significant elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.04 SUVR (normal ); Amyloid beta: 1249.00 pg/mL (normal ); Total tau: 162.40 pg/mL (normal ); Phosphorylated tau: 17.31 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound atrophy in the hippocampus and entorhinal cortex, along with significant whole brain and middle temporal gyrus atrophy, which are hallmark structural changes in Alzheimer's disease (AD). However, cognitive testing (MMSE 30, MoCA 24) suggests only mild cognitive impairment (MCI), and biomarkers (Aβ, tau, AV45) are normal, which is atypical for AD.  \n\n**Diagnosis:** **MCI** (given cognitive decline on MoCA but preserved function and normal biomarkers).  \n**Confidence:** **Medium** (due to conflicting structural and biomarker findings).",
  "timestamp": "2025-07-26T07:15:24.827058"
}