{
  "ptid_time": "009_S_4543_2012-03-01",
  "img_path": "/data/qiuhui/data/adni/images/009_S_4543/2012-03-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,882 mm³, 36.3% below the reference mean. With a Z-score of -0.83 (20.3th percentile), this represents normal volume ; hippocampal volume measures 7,441 mm³, 4.6% above the reference mean. With a Z-score of 0.42 (66.3th percentile), this represents normal volume ; whole brain volume measures 1,078,240 mm³, 10.6% above the reference mean. With a Z-score of 1.34 (91.0th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,259 mm³, 16.0% above the reference mean. With a Z-score of 0.98 (83.6th percentile), this represents normal volume ; fusiform gyrus volume measures 20,691 mm³, 21.6% above the reference mean. With a Z-score of 1.97 (97.5th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 24,241 mm³, 26.5% above the reference mean. With a Z-score of 2.30 (98.9th percentile), this represents significant enlargement. ",
  "text_data": "Age is 70.1 years. Gender is Female. Education: 18 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Hematopoietic-Lymphatic; Renal-Genitourinary; Allergies or Drug Sensitivities. MMSE: 29.0. MoCA: 23.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.00 SUVR (normal ); Total tau: 233.10 pg/mL (normal ); Phosphorylated tau: 19.68 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The brain volume measures are largely normal or even enlarged, with no significant atrophy in key regions like the hippocampus or entorhinal cortex. The MMSE score is normal (29/30), but the MoCA (23/30) suggests mild cognitive impairment, though this could be influenced by factors other than neurodegeneration given the normal biomarkers (T-tau, P-tau, AV45) and lack of APOE4 risk allele.  \n\nDiagnosis: **MCI** (Mild Cognitive Impairment)  \nConfidence: **Medium** (due to the discrepancy between MMSE and MoCA, but lack of structural or biomarker evidence for dementia)",
  "timestamp": "2025-07-25T22:21:29.926050"
}