{
  "ptid_time": "067_S_2195_2010-11-19",
  "img_path": "/data/qiuhui/data/adni/images/067_S_2195/2010-11-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 38,627 mm³, 28.6% above the reference mean. With a Z-score of 0.68 (75.2th percentile), this represents normal volume ; hippocampal volume measures 7,853 mm³, 2.2% below the reference mean. With a Z-score of -0.22 (41.4th percentile), this represents normal volume ; whole brain volume measures 1,177,220 mm³, 3.8% above the reference mean. With a Z-score of 0.53 (70.3th percentile), this represents normal volume ; entorhinal cortex volume measures 4,217 mm³, 1.1% below the reference mean. With a Z-score of -0.07 (47.0th percentile), this represents normal volume ; fusiform gyrus volume measures 19,484 mm³, 2.1% below the reference mean. With a Z-score of -0.18 (43.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,614 mm³, 12.5% below the reference mean. With a Z-score of -1.03 (15.2th percentile), this represents mild atrophy. ",
  "text_data": "Age is 68.0 years. Gender is Male. Education: 13 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Gastrointestinal; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 29.0. MoCA: 27.0. Logical Memory: 9.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.54 SUVR (profound elevated); Amyloid beta: 796.00 pg/mL (normal ); Total tau: 413.80 pg/mL (significant elevated); Phosphorylated tau: 49.19 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mostly normal measurements, with only mild atrophy in the middle temporal gyrus. However, the biomarker profile (elevated T-tau, P-tau, and AV45) strongly suggests Alzheimer's pathology despite normal Aβ levels. The cognitive scores (MMSE 29, MoCA 27) are within normal limits, but the APOE4 homozygosity increases risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given biomarker evidence).  \n**Confidence:** **Medium** (cognitive scores are borderline, but biomarkers strongly support neurodegeneration).",
  "timestamp": "2025-07-26T08:32:48.729820"
}