{
  "ptid_time": "072_S_4131_2011-10-31",
  "img_path": "/data/qiuhui/data/adni/images/072_S_4131/2011-10-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,851 mm³, 13.1% below the reference mean. With a Z-score of -0.38 (35.2th percentile), this represents normal volume ; hippocampal volume measures 4,644 mm³, 33.4% below the reference mean. With a Z-score of -2.88 (0.2th percentile), this represents significant atrophy; whole brain volume measures 1,003,240 mm³, 2.5% below the reference mean. With a Z-score of -0.33 (37.1th percentile), this represents normal volume ; entorhinal cortex volume measures 2,704 mm³, 31.9% below the reference mean. With a Z-score of -2.09 (1.8th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,171 mm³, 16.0% below the reference mean. With a Z-score of -1.39 (8.3th percentile), this represents mild atrophy; middle temporal gyrus volume measures 15,440 mm³, 23.5% below the reference mean. With a Z-score of -2.10 (1.8th percentile), this represents significant atrophy. ",
  "text_data": "Age is 82.4 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: . MMSE: 24.0. MoCA: 18.0. Logical Memory: 1.0. Laboratory findings: Creatinine (Rate Blanked): 1.70 (profound elevated). APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.50 SUVR (profound elevated); Amyloid beta: 589.10 pg/mL (mild reduced); Total tau: 308.60 pg/mL (normal ); Phosphorylated tau: 28.22 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus, entorhinal cortex, and middle temporal gyrus—key regions affected in Alzheimer's disease (AD). The MMSE (24) and MoCA (18) scores indicate cognitive impairment, while elevated AV45 (amyloid PET) and mildly reduced Aβ (CSF) support AD pathology.  \n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** High  \n\n*(Rationale: Structural atrophy in AD-vulnerable regions, amyloid positivity, and cognitive deficits align strongly with AD dementia. APOE4 carrier status further supports this. Low confidence in MCI is due to MMSE/MoCA scores falling into dementia range.)*",
  "timestamp": "2025-07-26T09:18:01.525380"
}