{
  "ptid_time": "153_S_4125_2011-07-20",
  "img_path": "/data/qiuhui/data/adni/images/153_S_4125/2011-07-20/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 28,576 mm³, 1.8% above the reference mean. With a Z-score of 0.04 (51.7th percentile), this represents normal volume ; hippocampal volume measures 6,948 mm³, 2.3% below the reference mean. With a Z-score of -0.21 (41.5th percentile), this represents normal volume ; whole brain volume measures 929,173 mm³, 4.7% below the reference mean. With a Z-score of -0.59 (27.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,412 mm³, 7.1% below the reference mean. With a Z-score of -0.44 (33.1th percentile), this represents normal volume ; fusiform gyrus volume measures 19,235 mm³, 13.1% above the reference mean. With a Z-score of 1.19 (88.3th percentile), this represents mild enlargement; middle temporal gyrus volume measures 19,776 mm³, 3.2% above the reference mean. With a Z-score of 0.27 (60.8th percentile), this represents normal volume . ",
  "text_data": "Age is 75.8 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Gastrointestinal; Major Surgical Procedures. MMSE: 30.0. MoCA: 24.0. Logical Memory: 11.0. Laboratory findings: MCH: 34.00 (significant elevated); Monocytes: 10.30 (significant elevated); RBC: 3.60 (significant reduced); Creatine Kinase: 201.00 (significant elevated); Triglycerides (GPO): 242.00 (significant elevated). APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 0.95 SUVR (mild reduced); Amyloid beta: 1685.00 pg/mL (moderate elevated); Total tau: 159.10 pg/mL (mild reduced); Phosphorylated tau: 14.88 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with only the fusiform gyrus showing mild enlargement. The MMSE score of 30 is normal, but the MoCA score of 24 suggests mild cognitive impairment (MCI). The presence of moderate Aβ elevation supports underlying Alzheimer's pathology, while normal P-tau and reduced T-tau/Aβ ratio may indicate early-stage changes.  \n\n**Diagnosis:** **MCI** (likely due to Alzheimer's pathology)  \n**Confidence:** **Medium** (clinical and biomarker data suggest MCI, but cognitive testing is borderline and neurodegeneration markers are not strongly elevated).",
  "timestamp": "2025-07-26T17:10:38.951982"
}