{
  "ptid_time": "027_S_4729_2012-08-11",
  "img_path": "/data/qiuhui/data/adni/images/027_S_4729/2012-08-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,909 mm³, 24.4% above the reference mean. With a Z-score of 0.56 (71.2th percentile), this represents normal volume ; hippocampal volume measures 5,365 mm³, 24.6% below the reference mean. With a Z-score of -2.26 (1.2th percentile), this represents significant atrophy; whole brain volume measures 929,302 mm³, 4.7% below the reference mean. With a Z-score of -0.59 (27.9th percentile), this represents normal volume . ",
  "text_data": "Age is 77.8 years. Gender is Female. Education: 19 years. Handedness: Right. Race: White. Medical history: Psychiatric; Cardiovascular; Musculoskeletal; Gastrointestinal; Allergies or Drug Sensitivities; Smoking; Malignancy. MMSE: 27.0. MoCA: 20.0. Logical Memory: 2.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.68 SUVR (profound elevated); Amyloid beta: 748.80 pg/mL (normal ); Total tau: 760.00 pg/mL (profound elevated); Phosphorylated tau: 74.27 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.26, 1.2th percentile), which is strongly associated with Alzheimer's pathology. The MMSE is normal (27/30), but the MoCA (20/30) suggests mild cognitive impairment. Biomarkers (elevated T-tau, P-tau, and AV45) indicate amyloid pathology and neurodegeneration, despite normal Aβ.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI) due to Alzheimer’s disease**  \n**Confidence:** **High**  \n\n(Key findings: hippocampal atrophy + abnormal tau/AV45 with preserved MMSE but impaired MoCA strongly suggest early Alzheimer’s pathology in the MCI stage.)",
  "timestamp": "2025-07-26T03:56:42.470830"
}