{
  "ptid_time": "018_S_4809_2014-06-19",
  "img_path": "/data/qiuhui/data/adni/images/018_S_4809/2014-06-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 59,998 mm³, 27.6% above the reference mean. With a Z-score of 0.80 (78.9th percentile), this represents normal volume ; hippocampal volume measures 7,398 mm³, 6.2% above the reference mean. With a Z-score of 0.53 (70.3th percentile), this represents normal volume ; whole brain volume measures 1,110,620 mm³, 7.9% above the reference mean. With a Z-score of 1.04 (85.0th percentile), this represents mild enlargement. ",
  "text_data": "Age is 80.3 years. Gender is Male. Education: 12 years. MMSE: 27.0. MoCA: 19.0. Logical Memory: 6.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.62 SUVR (profound elevated); Amyloid beta: 1136.00 pg/mL (normal ); Total tau: 293.00 pg/mL (normal ); Phosphorylated tau: 27.42 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volumes (ventricular, hippocampal, and whole brain) are within normal ranges or mildly enlarged, suggesting no significant atrophy. However, the MoCA score of 19 indicates cognitive impairment, while the MMSE of 27 is borderline normal. The normal CSF biomarkers (Aβ, T-tau, P-tau) but profoundly elevated AV45 (amyloid PET) suggest possible amyloid deposition despite normal CSF Aβ, which can occur in some cases.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—normal CSF Aβ but elevated AV45—and borderline MMSE vs. impaired MoCA)",
  "timestamp": "2025-07-26T01:00:27.410398"
}