{
  "ptid_time": "116_S_4898_2012-08-08",
  "img_path": "/data/qiuhui/data/adni/images/116_S_4898/2012-08-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,165 mm³, 4.3% above the reference mean. With a Z-score of 0.10 (54.1th percentile), this represents normal volume ; hippocampal volume measures 5,955 mm³, 21.2% below the reference mean. With a Z-score of -2.07 (1.9th percentile), this represents significant atrophy; whole brain volume measures 1,113,680 mm³, 3.2% above the reference mean. With a Z-score of 0.41 (66.0th percentile), this represents normal volume ; entorhinal cortex volume measures 2,700 mm³, 34.2% below the reference mean. With a Z-score of -2.32 (1.0th percentile), this represents significant atrophy; fusiform gyrus volume measures 20,806 mm³, 10.4% above the reference mean. With a Z-score of 0.89 (81.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,863 mm³, 11.8% above the reference mean. With a Z-score of 1.06 (85.6th percentile), this represents mild enlargement. ",
  "text_data": "Age is 75.2 years. Gender is Male. Education: 20 years. Handedness: Left. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Hematopoietic-Lymphatic; Renal-Genitourinary; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 30.0. MoCA: 29.0. Logical Memory: 10.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.14 SUVR (normal ); Amyloid beta: 711.20 pg/mL (normal ); Total tau: 161.70 pg/mL (normal ); Phosphorylated tau: 16.42 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging shows significant atrophy in the hippocampus and entorhinal cortex (both in the bottom 2nd percentile), which are key regions affected in Alzheimer's disease. However, cognitive testing (MMSE 30, MoCA 29) is intact, and CSF/AV45 biomarkers are normal, suggesting no current clinical impairment.  \n\n**Diagnosis:** **MCI** (structural changes suggest neurodegeneration, but cognition remains preserved).  \n**Confidence:** **Medium** (biomarkers are normal, but hippocampal/entorhinal atrophy is strongly suggestive of early pathology).  \n\n*Note: Given the discrepancy between imaging and biomarkers, this could represent preclinical AD or non-AD neurodegeneration (e.g., primary age-related tauopathy). Follow-up cognitive testing is recommended.*",
  "timestamp": "2025-07-26T12:17:29.741898"
}