{
  "ptid_time": "073_S_4825_2012-06-26",
  "img_path": "/data/qiuhui/data/adni/images/073_S_4825/2012-06-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 22,261 mm³, 42.2% below the reference mean. With a Z-score of -1.01 (15.6th percentile), this represents mild atrophy; hippocampal volume measures 9,020 mm³, 19.3% above the reference mean. With a Z-score of 1.89 (97.0th percentile), this represents moderate enlargement; whole brain volume measures 1,173,190 mm³, 8.7% above the reference mean. With a Z-score of 1.13 (87.0th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,247 mm³, 3.6% above the reference mean. With a Z-score of 0.24 (59.6th percentile), this represents normal volume ; fusiform gyrus volume measures 21,008 mm³, 11.5% above the reference mean. With a Z-score of 0.98 (83.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,296 mm³, 9.2% above the reference mean. With a Z-score of 0.82 (79.5th percentile), this represents normal volume . ",
  "text_data": "Age is 71.9 years. Gender is Male. Education: 18 years. Medical history: Renal-Genitourinary; Major Surgical Procedures. MMSE: 29.0. MoCA: 24.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.98 SUVR (normal ); Amyloid beta: 1646.00 pg/mL (moderate elevated); Total tau: 228.60 pg/mL (normal ); Phosphorylated tau: 22.82 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mild ventricular atrophy but otherwise normal-to-enlarged volumes in key regions (hippocampus, whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus). Cognitive scores are borderline (MMSE 29 normal, MoCA 24 suggestive of mild impairment), but biomarkers show moderate Aβ elevation with normal tau and AV45, which is atypical for Alzheimer’s pathology.  \n\n**Diagnosis:** **MCI** (mild cognitive impairment, likely non-AD etiology given biomarker discordance)  \n**Confidence:** **Medium** (atypical biomarker profile and preserved hippocampal volume argue against AD, but MoCA suggests cognitive decline).",
  "timestamp": "2025-07-26T09:53:19.838725"
}