{
  "ptid_time": "036_S_2380_2011-06-01",
  "img_path": "/data/qiuhui/data/adni/images/036_S_2380/2011-06-01/t1.nii.gz",
  "img_finding": "Image findings: hippocampal volume measures 7,620 mm³, 5.1% below the reference mean. With a Z-score of -0.51 (30.6th percentile), this represents normal volume ; whole brain volume measures 1,266,130 mm³, 11.6% above the reference mean. With a Z-score of 1.64 (95.0th percentile), this represents moderate enlargement; entorhinal cortex volume measures 3,589 mm³, 15.8% below the reference mean. With a Z-score of -1.09 (13.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 21,798 mm³, 9.5% above the reference mean. With a Z-score of 0.79 (78.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,676 mm³, 1.2% above the reference mean. With a Z-score of 0.10 (53.9th percentile), this represents normal volume . ",
  "text_data": "Age is 67.8 years. Gender is Male. Education: 16 years. MMSE: 28.0. MoCA: 23.0. Logical Memory: 8.0. Laboratory findings: AST (SGOT): 12.00 (significant reduced); Phosphorus: 2.40 (significant reduced). APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.33 SUVR (moderate elevated); Amyloid beta: 696.50 pg/mL (normal ); Total tau: 227.00 pg/mL (normal ); Phosphorylated tau: 21.81 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume is within normal limits, but the entorhinal cortex shows mild atrophy, which is an early marker of Alzheimer's pathology. The MoCA score of 23 suggests mild cognitive impairment, while the MMSE of 28 is borderline normal. Biomarkers (Aβ, tau) are normal, but AV45 (amyloid PET) is moderately elevated, indicating amyloid deposition.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology given amyloid elevation and entorhinal atrophy).  \n\n**Confidence:** **Medium** (due to conflicting biomarker results—normal CSF Aβ/tau but elevated AV45—and only mild entorhinal atrophy).",
  "timestamp": "2025-07-26T06:11:17.620445"
}