{
  "ptid_time": "035_S_4256_2011-12-14",
  "img_path": "/data/qiuhui/data/adni/images/035_S_4256/2011-12-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 21,504 mm³, 3.7% below the reference mean. With a Z-score of -0.09 (46.3th percentile), this represents normal volume ; hippocampal volume measures 6,613 mm³, 13.9% below the reference mean. With a Z-score of -1.56 (5.9th percentile), this represents moderate atrophy; whole brain volume measures 1,077,820 mm³, 4.7% above the reference mean. With a Z-score of 0.59 (72.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,662 mm³, 5.9% below the reference mean. With a Z-score of -0.46 (32.3th percentile), this represents normal volume ; fusiform gyrus volume measures 21,073 mm³, 15.7% above the reference mean. With a Z-score of 1.77 (96.2th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 20,226 mm³, 1.4% below the reference mean. With a Z-score of -0.13 (44.9th percentile), this represents normal volume . ",
  "text_data": "Age is 62.8 years. Gender is Female. Education: 20 years. Handedness: Right. Race: White. Medical history: Psychiatric; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. MoCA: 26.0. Logical Memory: 9.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.19 SUVR (normal ); Amyloid beta: 1389.00 pg/mL (normal ); Total tau: 210.90 pg/mL (normal ); Phosphorylated tau: 17.51 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.56, 5.9th percentile), which is a key biomarker for Alzheimer's pathology, while other brain regions are largely normal. Cognitive scores (MMSE 29, MoCA 26) are borderline for MCI but still within normal range. Biomarkers (Aβ, tau, AV45) are normal, ruling out significant amyloid or tau pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to hippocampal atrophy but normal biomarkers and near-normal cognitive scores)",
  "timestamp": "2025-07-26T05:55:43.339726"
}