{
  "ptid_time": "023_S_4035_2011-07-28",
  "img_path": "/data/qiuhui/data/adni/images/023_S_4035/2011-07-28/t1.nii.gz",
  "img_finding": "Image findings: hippocampal volume measures 7,620 mm³, 7.1% above the reference mean. With a Z-score of 0.65 (74.3th percentile), this represents normal volume ; whole brain volume measures 1,002,410 mm³, 2.8% above the reference mean. With a Z-score of 0.36 (64.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,232 mm³, 12.0% below the reference mean. With a Z-score of -0.74 (23.1th percentile), this represents normal volume ; fusiform gyrus volume measures 16,815 mm³, 1.2% below the reference mean. With a Z-score of -0.11 (45.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,051 mm³, 4.6% above the reference mean. With a Z-score of 0.40 (65.5th percentile), this represents normal volume . ",
  "text_data": "Age is 72.6 years. Gender is Female. Education: 16 years. MMSE: 26.0. MoCA: 19.0. Logical Memory: 8.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.53 SUVR (profound elevated); Amyloid beta: 623.40 pg/mL (mild reduced); Total tau: 454.50 pg/mL (significant elevated); Phosphorylated tau: 44.09 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows normal brain volumes in most regions, except for a mild reduction in the entorhinal cortex. However, cognitive testing (MoCA 19) suggests impairment, and biomarker data (elevated T-tau, P-tau, and AV45 with mildly reduced Aβ) strongly support Alzheimer's pathology. The MMSE of 26 is borderline, but the MoCA is more sensitive to early cognitive decline.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**  \n\n(Key factors: Biomarkers strongly indicate AD pathology, MoCA confirms cognitive impairment, and entorhinal cortex reduction aligns with early AD despite other volumes being normal.)",
  "timestamp": "2025-07-26T03:01:11.342360"
}