{
  "ptid_time": "027_S_1045_2012-11-20",
  "img_path": "/data/qiuhui/data/adni/images/027_S_1045/2012-11-20/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,864 mm³, 7.8% above the reference mean. With a Z-score of 0.21 (58.4th percentile), this represents normal volume ; whole brain volume measures 868,032 mm³, 6.5% below the reference mean. With a Z-score of -0.78 (21.8th percentile), this represents normal volume . ",
  "text_data": "Age is 88.6 years. Gender is Female. Education: 14 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Major Surgical Procedures. MMSE: 28.0. MoCA: 22.0. Logical Memory: 2.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.93 SUVR (mild reduced); Total tau: 258.10 pg/mL (normal ); Phosphorylated tau: 21.08 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows normal ventricular and whole brain volumes, with only mild reductions in whole brain volume (Z-score -0.78). Cognitive testing reveals a high MMSE (28/30) but a borderline MoCA (22/30), suggesting possible mild cognitive deficits. Biomarkers (T-tau, P-tau, AV45) are mostly normal or mildly reduced, with no APOE4 risk allele.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to borderline MoCA and mild AV45 reduction, but otherwise normal biomarkers and brain volumes)",
  "timestamp": "2025-07-26T03:45:04.272549"
}