{
  "ptid_time": "006_S_4713_2014-06-06",
  "img_path": "/data/qiuhui/data/adni/images/006_S_4713/2014-06-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 25,958 mm³, 32.6% below the reference mean. With a Z-score of -0.78 (21.7th percentile), this represents normal volume ; hippocampal volume measures 9,678 mm³, 28.0% above the reference mean. With a Z-score of 2.73 (99.7th percentile), this represents significant enlargement; whole brain volume measures 1,165,160 mm³, 7.9% above the reference mean. With a Z-score of 1.03 (84.9th percentile), this represents mild enlargement; entorhinal cortex volume measures 5,937 mm³, 44.8% above the reference mean. With a Z-score of 3.04 (99.9th percentile), this represents profound enlargement; fusiform gyrus volume measures 18,653 mm³, 1.0% below the reference mean. With a Z-score of -0.08 (46.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,969 mm³, 12.3% above the reference mean. With a Z-score of 1.11 (86.6th percentile), this represents mild enlargement. ",
  "text_data": "Age is 72.5 years. Gender is Male. Education: 20 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 12.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.28 SUVR (moderate elevated); Amyloid beta: 800.50 pg/mL (normal ); Total tau: 365.10 pg/mL (moderate elevated); Phosphorylated tau: 34.36 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "Reasoning: The brain volume data shows significant enlargement in the hippocampus, entorhinal cortex, and mild enlargement in the whole brain and middle temporal gyrus, which is atypical for Alzheimer's disease (AD). The MMSE is normal (30/30), but the MoCA (26/30) suggests mild cognitive concerns. Biomarkers show normal Aβ but elevated T-tau, P-tau, and AV45, which could indicate tauopathy or another neurodegenerative process rather than typical AD.  \nDiagnosis: MCI (Mild Cognitive Impairment)  \nConfidence: Medium (due to conflicting imaging and biomarker patterns)",
  "timestamp": "2025-07-25T21:40:56.506035"
}