{
  "ptid_time": "027_S_5109_2013-03-25",
  "img_path": "/data/qiuhui/data/adni/images/027_S_5109/2013-03-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 52,953 mm³, 37.5% above the reference mean. With a Z-score of 0.90 (81.5th percentile), this represents normal volume ; hippocampal volume measures 6,827 mm³, 9.7% below the reference mean. With a Z-score of -0.94 (17.2th percentile), this represents normal volume ; whole brain volume measures 1,014,390 mm³, 6.0% below the reference mean. With a Z-score of -0.78 (21.7th percentile), this represents normal volume ; entorhinal cortex volume measures 4,203 mm³, 2.5% above the reference mean. With a Z-score of 0.17 (56.7th percentile), this represents normal volume ; fusiform gyrus volume measures 18,440 mm³, 2.1% below the reference mean. With a Z-score of -0.18 (42.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,805 mm³, 2.2% above the reference mean. With a Z-score of 0.20 (57.8th percentile), this represents normal volume . ",
  "text_data": "Age is 78.4 years. Gender is Male. Education: 14 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Smoking; Malignancy. MMSE: 27.0. MoCA: 23.0. Logical Memory: 10.0. Laboratory findings: Vitamin B12: 994.00 (significant elevated); MCH: 36.00 (profound elevated); Platelets: 397.00 (significant elevated); Monocytes: 10.30 (significant elevated); Basophils: 0.00 (significant reduced); Calcium (EDTA): 10.70 (significant elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.39 SUVR (significant elevated); Amyloid beta: 771.90 pg/mL (normal ); Total tau: 207.20 pg/mL (normal ); Phosphorylated tau: 17.63 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are all within normal ranges, with no significant atrophy in key regions like the hippocampus or entorhinal cortex. However, the MoCA score of 23 suggests mild cognitive impairment (MCI), while the MMSE of 27 is borderline. The elevated AV45 (amyloid PET) indicates amyloid pathology, but CSF biomarkers (Aβ, T-tau, P-tau) are normal, creating some inconsistency.  \n\n**Diagnosis:** **MCI** (likely amyloid-positive but without clear neurodegeneration biomarkers).  \n**Confidence:** **Medium** (due to conflicting MoCA/MMSE and AV45 vs. CSF results).",
  "timestamp": "2025-07-26T04:07:58.409970"
}