{
  "ptid_time": "153_S_5267_2013-08-01",
  "img_path": "/data/qiuhui/data/adni/images/153_S_5267/2013-08-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 7,296 mm³, 67.3% below the reference mean. With a Z-score of -1.69 (4.6th percentile), this represents moderate atrophy; hippocampal volume measures 7,140 mm³, 7.1% below the reference mean. With a Z-score of -0.80 (21.3th percentile), this represents normal volume ; whole brain volume measures 870,023 mm³, 15.5% below the reference mean. With a Z-score of -1.93 (2.7th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,146 mm³, 19.2% below the reference mean. With a Z-score of -1.49 (6.9th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,583 mm³, 3.4% below the reference mean. With a Z-score of -0.39 (34.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,023 mm³, 12.2% below the reference mean. With a Z-score of -1.08 (14.0th percentile), this represents mild atrophy. ",
  "text_data": "Age is 65.8 years. Gender is Female. Education: 15 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 28.0. MoCA: 27.0. Logical Memory: 15.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.14 SUVR (normal ); Amyloid beta: 1086.00 pg/mL (normal ); Total tau: 360.10 pg/mL (moderate elevated); Phosphorylated tau: 31.20 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows moderate atrophy in ventricular and whole brain volumes, along with mild atrophy in the entorhinal cortex and middle temporal gyrus, while hippocampal and fusiform gyrus volumes remain normal. Clinically, cognitive scores (MMSE 28, MoCA 27) are within normal limits, but biomarkers indicate moderate T-tau and mild P-tau elevation despite normal Aβ and AV45. This suggests possible early neurodegenerative changes without significant cognitive impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Biomarkers and atrophy suggest neurodegeneration, but cognitive scores are preserved, making early MCI more likely than dementia.)",
  "timestamp": "2025-07-26T17:16:18.304126"
}