{
  "ptid_time": "130_S_4352_2011-11-15",
  "img_path": "/data/qiuhui/data/adni/images/130_S_4352/2011-11-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 45,933 mm³, 2.3% below the reference mean. With a Z-score of -0.07 (47.3th percentile), this represents normal volume ; hippocampal volume measures 6,247 mm³, 10.3% below the reference mean. With a Z-score of -0.89 (18.6th percentile), this represents normal volume ; whole brain volume measures 1,042,030 mm³, 1.3% above the reference mean. With a Z-score of 0.16 (56.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,566 mm³, 10.2% below the reference mean. With a Z-score of -0.66 (25.3th percentile), this represents normal volume ; fusiform gyrus volume measures 16,226 mm³, 10.2% below the reference mean. With a Z-score of -0.88 (18.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,871 mm³, 1.5% below the reference mean. With a Z-score of -0.13 (44.7th percentile), this represents normal volume . ",
  "text_data": "Age is 83.6 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Smoking; Malignancy; Major Surgical Procedures. MMSE: 29.0. MoCA: 24.0. Logical Memory: 13.0. Laboratory findings: . APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.06 SUVR (normal ); Total tau: 257.70 pg/mL (normal ); Phosphorylated tau: 23.04 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are all within normal ranges (Z-scores between -0.89 and +0.16), with no significant atrophy in key regions like the hippocampus or entorhinal cortex. Cognitive scores (MMSE 29, MoCA 24) are borderline for MCI (MoCA <26 suggests possible impairment), but biomarkers (normal tau, amyloid) and APOE4-negative status do not strongly support neurodegeneration.  \n\n**Diagnosis:** **MCI** (due to borderline MoCA, but no clear dementia or biomarker evidence of Alzheimer’s).  \n**Confidence:** **Medium** (clinical suspicion for MCI exists, but structural and biomarker data are unremarkable).",
  "timestamp": "2025-07-26T14:40:27.661759"
}