{
  "ptid_time": "126_S_4458_2012-01-20",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4458/2012-01-20/t1.nii.gz",
  "img_finding": "Image findings: hippocampal volume measures 6,618 mm³, 7.0% below the reference mean. With a Z-score of -0.64 (26.1th percentile), this represents normal volume ; whole brain volume measures 997,774 mm³, 2.4% above the reference mean. With a Z-score of 0.30 (61.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,000 mm³, 18.3% below the reference mean. With a Z-score of -1.12 (13.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,237 mm³, 4.6% below the reference mean. With a Z-score of -0.42 (33.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,503 mm³, 8.7% below the reference mean. With a Z-score of -0.75 (22.5th percentile), this represents normal volume . ",
  "text_data": "Age is 76.1 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Gastrointestinal; Smoking; Major Surgical Procedures. MMSE: 27.0. MoCA: 17.0. Logical Memory: 6.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.44 SUVR (significant elevated); Amyloid beta: 651.30 pg/mL (normal ); Total tau: 457.30 pg/mL (significant elevated); Phosphorylated tau: 51.53 pg/mL (profound elevated). ",
  "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 MMSE is normal (27/30), but the MoCA is significantly impaired (17/30), suggesting cognitive deficits consistent with MCI. Biomarkers (elevated T-tau, P-tau, and AV45) strongly support Alzheimer’s pathology despite normal Aβ.  \n\n**Diagnosis:** **MCI (likely due to Alzheimer’s disease)**  \n**Confidence:** **High**  \n\n*(The MoCA score is disproportionately low compared to MMSE, which is common in early Alzheimer’s-related MCI. Biomarkers confirm neurodegeneration and amyloid deposition, but preserved hippocampal volume and normal Aβ suggest early-stage disease.)*",
  "timestamp": "2025-07-26T12:45:22.530088"
}