{
  "ptid_time": "135_S_4566_2012-03-07",
  "img_path": "/data/qiuhui/data/adni/images/135_S_4566/2012-03-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 25,901 mm³, 29.9% below the reference mean. With a Z-score of -0.81 (21.0th percentile), this represents normal volume ; hippocampal volume measures 7,483 mm³, 15.2% above the reference mean. With a Z-score of 1.22 (88.9th percentile), this represents mild enlargement; whole brain volume measures 984,025 mm³, 6.0% above the reference mean. With a Z-score of 0.72 (76.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,406 mm³, 1.6% below the reference mean. With a Z-score of -0.09 (46.5th percentile), this represents normal volume ; fusiform gyrus volume measures 16,598 mm³, 3.0% above the reference mean. With a Z-score of 0.23 (59.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,623 mm³, 2.3% below the reference mean. With a Z-score of -0.20 (42.1th percentile), this represents normal volume . ",
  "text_data": "Age is 83.4 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Musculoskeletal; Gastrointestinal. MMSE: 29.0. MoCA: 26.0. Logical Memory: 13.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.19 SUVR (normal ); Amyloid beta: 1653.00 pg/mL (moderate elevated); Total tau: 347.40 pg/mL (mild elevated); Phosphorylated tau: 33.37 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with mild hippocampal enlargement. Cognitive scores (MMSE 29, MoCA 26) are near normal, but biomarker data (elevated Aβ, T-tau, and P-tau) suggest Alzheimer's pathology. The discrepancy between preserved cognition and biomarker abnormalities may indicate preclinical or very early-stage disease.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology)  \n**Confidence:** **Medium** (due to normal cognition but significant biomarker evidence of AD pathology)  \n\n*Note: Given the high MMSE/MoCA, some might argue for \"Cognitively Normal (CN) with biomarker evidence of AD,\" but MCI is more likely given the tau elevation and age. Follow-up cognitive testing would help clarify progression.*",
  "timestamp": "2025-07-26T15:38:00.983806"
}