{
  "ptid_time": "002_S_5178_2013-05-16",
  "img_path": "/data/qiuhui/data/adni/images/002_S_5178/2013-05-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 21,770 mm³, 27.5% below the reference mean. With a Z-score of -0.65 (25.7th percentile), this represents normal volume ; hippocampal volume measures 7,763 mm³, 3.3% below the reference mean. With a Z-score of -0.33 (37.1th percentile), this represents normal volume ; whole brain volume measures 1,092,900 mm³, 3.7% below the reference mean. With a Z-score of -0.52 (30.2th percentile), this represents normal volume ; entorhinal cortex volume measures 4,467 mm³, 4.8% above the reference mean. With a Z-score of 0.33 (63.0th percentile), this represents normal volume ; fusiform gyrus volume measures 17,405 mm³, 12.6% below the reference mean. With a Z-score of -1.05 (14.8th percentile), this represents mild atrophy; middle temporal gyrus volume measures 21,100 mm³, 5.9% below the reference mean. With a Z-score of -0.48 (31.5th percentile), this represents normal volume . ",
  "text_data": "Age is 68.6 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Respiratory; Musculoskeletal; Allergies or Drug Sensitivities; Smoking. MMSE: 27.0. MoCA: 21.0. Logical Memory: 9.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.04 SUVR (normal ); Amyloid beta: 1623.00 pg/mL (moderate elevated); Total tau: 236.50 pg/mL (normal ); Phosphorylated tau: 20.96 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with only mild atrophy noted in the fusiform gyrus. The MMSE score of 27 is normal, but the MoCA score of 21 suggests mild cognitive impairment (MCI). Biomarkers show moderately elevated Aβ (indicating amyloid pathology) but normal tau and AV45, which is atypical for Alzheimer’s but may suggest early amyloid accumulation.  \n\n**Diagnosis:** **MCI** (likely amnestic subtype given MoCA score, but not strongly supported by hippocampal atrophy).  \n\n**Confidence:** **Medium** (due to conflicting biomarker and imaging findings—elevated Aβ without tauopathy or significant atrophy complicates the picture).",
  "timestamp": "2025-07-25T20:33:12.930449"
}