{
  "ptid_time": "013_S_2389_2011-06-22",
  "img_path": "/data/qiuhui/data/adni/images/013_S_2389/2011-06-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 18,641 mm³, 0.1% above the reference mean. With a Z-score of 0.00 (50.1th percentile), this represents normal volume ; hippocampal volume measures 7,578 mm³, 2.9% below the reference mean. With a Z-score of -0.41 (34.1th percentile), this represents normal volume ; whole brain volume measures 1,008,760 mm³, 3.1% below the reference mean. With a Z-score of -0.37 (35.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,429 mm³, 7.2% below the reference mean. With a Z-score of -0.56 (28.6th percentile), this represents normal volume ; fusiform gyrus volume measures 15,852 mm³, 14.0% below the reference mean. With a Z-score of -1.27 (10.2th percentile), this represents mild atrophy; middle temporal gyrus volume measures 20,272 mm³, 1.3% below the reference mean. With a Z-score of -0.10 (45.8th percentile), this represents normal volume . ",
  "text_data": "Age is 57.8 years. Gender is Female. Education: 15 years. Handedness: Right. Race: Unknown. Medical history: Musculoskeletal; Malignancy; Major Surgical Procedures. MMSE: 29.0. MoCA: 23.0. Logical Memory: 8.0. Laboratory findings: . APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.94 SUVR (mild reduced); Amyloid beta: 881.00 pg/mL (normal ); Total tau: 128.90 pg/mL (mild reduced); Phosphorylated tau: 11.73 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild atrophy in the fusiform gyrus (Z-score -1.27, 10.2th percentile), while other regions (hippocampus, entorhinal cortex, whole brain) are within normal ranges. The MMSE is normal (29/30), but the MoCA (23/30) suggests possible mild cognitive impairment (MCI). Biomarkers (Aβ normal, T-tau/P-tau mildly reduced) do not strongly support Alzheimer’s pathology.  \n\n**Diagnosis:** **MCI** (due to MoCA score and fusiform gyrus atrophy, but no clear dementia or biomarker evidence of Alzheimer’s).  \n\n**Confidence:** **Medium** (MoCA is borderline, atrophy is mild and isolated, and biomarkers are inconclusive).",
  "timestamp": "2025-07-25T23:29:31.781332"
}