{
  "ptid_time": "032_S_2119_2010-10-05",
  "img_path": "/data/qiuhui/data/adni/images/032_S_2119/2010-10-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,728 mm³, 4.6% below the reference mean. With a Z-score of -0.11 (45.6th percentile), this represents normal volume ; hippocampal volume measures 6,906 mm³, 8.6% below the reference mean. With a Z-score of -0.84 (20.0th percentile), this represents normal volume ; whole brain volume measures 1,088,760 mm³, 0.9% above the reference mean. With a Z-score of 0.11 (54.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,602 mm³, 12.2% below the reference mean. With a Z-score of -0.82 (20.5th percentile), this represents normal volume ; fusiform gyrus volume measures 19,454 mm³, 3.3% above the reference mean. With a Z-score of 0.28 (61.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,761 mm³, 2.0% above the reference mean. With a Z-score of 0.18 (57.1th percentile), this represents normal volume . ",
  "text_data": "Age is 71.7 years. Gender is Male. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Cardiovascular; Respiratory; Musculoskeletal; Endocrine-Metabolic; Renal-Genitourinary; Smoking; Major Surgical Procedures. MMSE: 29.0. MoCA: 20.0. Logical Memory: 7.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.11 SUVR (normal ); Total tau: 315.70 pg/mL (normal ); Phosphorylated tau: 23.45 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are within normal ranges (Z-scores between -0.84 and +0.28), and CSF biomarkers (T-tau, P-tau, AV45) are normal. However, the MoCA score of 20 suggests mild cognitive impairment (MCI), while the MMSE of 29 is borderline normal. The discrepancy between MMSE and MoCA, along with preserved biomarkers, points to MCI rather than dementia.  \n\n**Diagnosis:** MCI  \n**Confidence:** Medium (due to conflicting cognitive test results but normal biomarkers and imaging)",
  "timestamp": "2025-07-26T05:01:20.825550"
}