{
  "ptid_time": "127_S_4210_2015-09-16",
  "img_path": "/data/qiuhui/data/adni/images/127_S_4210/2015-09-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 13,782 mm³, 54.1% below the reference mean. With a Z-score of -1.29 (9.9th percentile), this represents mild atrophy; hippocampal volume measures 8,999 mm³, 12.1% above the reference mean. With a Z-score of 1.21 (88.7th percentile), this represents mild enlargement; whole brain volume measures 1,213,440 mm³, 7.0% above the reference mean. With a Z-score of 0.98 (83.8th percentile), this represents normal volume ; entorhinal cortex volume measures 4,333 mm³, 1.6% above the reference mean. With a Z-score of 0.11 (54.5th percentile), this represents normal volume ; fusiform gyrus volume measures 21,348 mm³, 7.2% above the reference mean. With a Z-score of 0.60 (72.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,794 mm³, 7.2% below the reference mean. With a Z-score of -0.59 (27.6th percentile), this represents normal volume . ",
  "text_data": "Age is 67.9 years. Gender is Male. Education: 18 years. MMSE: 29.0. MoCA: 26.0. Logical Memory: 6.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 0.99 SUVR (normal ); Amyloid beta: 1564.00 pg/mL (mild elevated); Total tau: 360.70 pg/mL (moderate elevated); Phosphorylated tau: 35.86 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild ventricular atrophy but otherwise normal or above-average volumes in key regions (hippocampus, whole brain, entorhinal cortex, fusiform gyrus, middle temporal gyrus). Clinically, the patient has high MMSE (29) and MoCA (26) scores, suggesting intact cognition, but CSF biomarkers (elevated Aβ, T-tau, P-tau) indicate early Alzheimer's pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer's due to biomarker profile).  \n\n**Confidence:** **Medium** (cognitive scores are strong, but biomarkers and ventricular atrophy suggest early neurodegenerative changes).",
  "timestamp": "2025-07-26T13:16:31.126600"
}