{
  "ptid_time": "033_S_1098_2012-12-05",
  "img_path": "/data/qiuhui/data/adni/images/033_S_1098/2012-12-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 23,158 mm³, 17.5% below the reference mean. With a Z-score of -0.40 (34.4th percentile), this represents normal volume ; hippocampal volume measures 5,642 mm³, 20.7% below the reference mean. With a Z-score of -1.90 (2.9th percentile), this represents moderate atrophy; whole brain volume measures 824,518 mm³, 15.4% below the reference mean. With a Z-score of -1.94 (2.6th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,811 mm³, 3.8% above the reference mean. With a Z-score of 0.23 (59.1th percentile), this represents normal volume ; fusiform gyrus volume measures 16,323 mm³, 4.1% below the reference mean. With a Z-score of -0.37 (35.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,488 mm³, 14.0% below the reference mean. With a Z-score of -1.21 (11.2th percentile), this represents mild atrophy. ",
  "text_data": "Age is 78.0 years. Gender is Female. Education: 15 years. MMSE: 29.0. MoCA: 25.0. Logical Memory: 20.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.66 SUVR (profound elevated); Amyloid beta: 528.00 pg/mL (mild reduced); Total tau: 488.20 pg/mL (profound elevated); Phosphorylated tau: 58.37 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "Reasoning: The hippocampal and whole brain volumes show moderate atrophy (Z-scores -1.90 and -1.94, respectively), which is concerning for neurodegeneration. The MMSE is normal (29/30), but the MoCA (25/30) suggests mild cognitive impairment, supported by elevated biomarkers (Aβ reduction, elevated tau, and AV45).  \nDiagnosis: MCI (likely due to Alzheimer’s pathology)  \nConfidence: Medium (imaging and biomarkers strongly suggest early neurodegeneration, but cognitive scores are borderline and clinical correlation is needed).",
  "timestamp": "2025-07-26T05:29:30.576623"
}