{
  "ptid_time": "128_S_4636_2012-03-27",
  "img_path": "/data/qiuhui/data/adni/images/128_S_4636/2012-03-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 22,503 mm³, 19.8% below the reference mean. With a Z-score of -0.45 (32.5th percentile), this represents normal volume ; hippocampal volume measures 5,996 mm³, 15.7% below the reference mean. With a Z-score of -1.44 (7.5th percentile), this represents mild atrophy; whole brain volume measures 936,074 mm³, 4.0% below the reference mean. With a Z-score of -0.50 (30.9th percentile), this represents normal volume ; entorhinal cortex volume measures 2,495 mm³, 32.1% below the reference mean. With a Z-score of -1.97 (2.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,048 mm³, 5.7% below the reference mean. With a Z-score of -0.52 (30.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 14,993 mm³, 21.8% below the reference mean. With a Z-score of -1.89 (2.9th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 77.1 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Cardiovascular; Endocrine-Metabolic; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 28.0. MoCA: 24.0. Logical Memory: 1.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.39 SUVR (significant elevated); Amyloid beta: 744.40 pg/mL (normal ); Total tau: 407.10 pg/mL (significant elevated); Phosphorylated tau: 30.40 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The patient shows mild hippocampal atrophy and moderate atrophy in the entorhinal cortex and middle temporal gyrus, which are key regions affected in Alzheimer's disease. Elevated T-tau, P-tau, and AV45 (amyloid PET) suggest amyloid pathology and neurodegeneration, despite normal Aβ levels. The MMSE (28) is near-normal, but the MoCA (24) indicates mild cognitive impairment.  \nDiagnosis: **MCI (likely due to Alzheimer’s pathology)**  \nConfidence: **Medium** (due to conflicting biomarkers—normal Aβ but elevated tau and AV45—and high-functioning MMSE despite structural atrophy)",
  "timestamp": "2025-07-26T14:03:34.845334"
}