{
  "ptid_time": "029_S_4290_2013-11-13",
  "img_path": "/data/qiuhui/data/adni/images/029_S_4290/2013-11-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 49,648 mm³, 28.9% above the reference mean. With a Z-score of 0.69 (75.6th percentile), this represents normal volume ; hippocampal volume measures 5,769 mm³, 23.7% below the reference mean. With a Z-score of -2.31 (1.0th percentile), this represents significant atrophy; whole brain volume measures 1,055,850 mm³, 2.2% below the reference mean. With a Z-score of -0.28 (38.9th percentile), this represents normal volume ; entorhinal cortex volume measures 3,766 mm³, 8.2% below the reference mean. With a Z-score of -0.55 (29.0th percentile), this represents normal volume ; fusiform gyrus volume measures 17,479 mm³, 7.2% below the reference mean. With a Z-score of -0.61 (26.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,975 mm³, 6.4% below the reference mean. With a Z-score of -0.57 (28.3th percentile), this represents normal volume . ",
  "text_data": "Age is 75.5 years. Gender is Male. Education: 20 years. MMSE: 29.0. MoCA: 25.0. Logical Memory: 9.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.13 SUVR (normal ); Amyloid beta: 866.30 pg/mL (normal ); Total tau: 403.30 pg/mL (significant elevated); Phosphorylated tau: 33.92 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.31, 1st percentile), which is strongly associated with Alzheimer's pathology. Elevated T-tau and P-tau further support neurodegeneration, despite normal Aβ and AV45 (suggesting absence of amyloid plaques). The MMSE (29) is normal, but the MoCA (25) indicates mild cognitive impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to underlying Alzheimer’s pathology given hippocampal atrophy and tau elevation).  \n\n**Confidence:** **High** (due to clear hippocampal atrophy, tau biomarkers, and MoCA score, despite normal amyloid).",
  "timestamp": "2025-07-26T04:27:33.069715"
}