{
  "ptid_time": "137_S_4258_2011-10-11",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4258/2011-10-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,708 mm³, 16.1% above the reference mean. With a Z-score of 0.39 (65.0th percentile), this represents normal volume ; hippocampal volume measures 6,697 mm³, 11.4% below the reference mean. With a Z-score of -1.11 (13.3th percentile), this represents mild atrophy; whole brain volume measures 1,239,580 mm³, 14.8% above the reference mean. With a Z-score of 1.93 (97.3th percentile), this represents moderate enlargement; entorhinal cortex volume measures 3,813 mm³, 7.0% below the reference mean. With a Z-score of -0.48 (31.7th percentile), this represents normal volume ; fusiform gyrus volume measures 20,263 mm³, 7.6% above the reference mean. With a Z-score of 0.64 (74.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,885 mm³, 2.6% above the reference mean. With a Z-score of 0.23 (59.1th percentile), this represents normal volume . ",
  "text_data": "Age is 75.8 years. Gender is Male. Education: 14 years. Handedness: Left. Race: White. Medical history: Psychiatric; Neurologic; Cardiovascular; Musculoskeletal; Renal-Genitourinary; Malignancy; Major Surgical Procedures. MMSE: 24.0. MoCA: 18.0. Logical Memory: 1.0. Laboratory findings: Total Bilirubin: 1.50 (profound elevated); Direct Bilirubin: 0.30 (significant elevated). APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.27 SUVR (mild elevated); Amyloid beta: 641.60 pg/mL (mild reduced); Total tau: 322.50 pg/mL (mild elevated); Phosphorylated tau: 34.52 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "Reasoning: The hippocampal volume shows mild atrophy (Z-score -1.11, 13.3th percentile), which is a key biomarker for Alzheimer's disease. Combined with mild Aβ reduction, mild-to-moderate tau elevation, and cognitive scores (MMSE 24, MoCA 18) below typical cutoffs for normal cognition, this suggests early neurodegenerative changes. However, other brain regions (entorhinal cortex, fusiform gyrus, middle temporal gyrus) remain within normal ranges.  \n\nDiagnosis: **Mild Cognitive Impairment (MCI)**  \nConfidence: **Medium** (Cognitive scores and hippocampal atrophy support MCI, but other regions are preserved, and biomarker elevations are not severe.)",
  "timestamp": "2025-07-26T16:28:50.734597"
}