{
  "ptid_time": "135_S_4406_2011-12-07",
  "img_path": "/data/qiuhui/data/adni/images/135_S_4406/2011-12-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 82,836 mm³, 115.1% above the reference mean. With a Z-score of 2.76 (99.7th percentile), this represents significant enlargement; hippocampal volume measures 6,986 mm³, 7.6% below the reference mean. With a Z-score of -0.74 (23.0th percentile), this represents normal volume ; whole brain volume measures 974,326 mm³, 9.7% below the reference mean. With a Z-score of -1.26 (10.3th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,295 mm³, 19.6% below the reference mean. With a Z-score of -1.33 (9.1th percentile), this represents mild atrophy; fusiform gyrus volume measures 18,010 mm³, 4.4% below the reference mean. With a Z-score of -0.37 (35.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,295 mm³, 9.6% below the reference mean. With a Z-score of -0.86 (19.5th percentile), this represents normal volume . ",
  "text_data": "Age is 78.9 years. Gender is Male. Education: 19 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Musculoskeletal; Endocrine-Metabolic; Renal-Genitourinary; Malignancy. MMSE: 29.0. MoCA: 24.0. Logical Memory: 4.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.28 SUVR (moderate elevated); Amyloid beta: 810.60 pg/mL (normal ); Total tau: 268.80 pg/mL (normal ); Phosphorylated tau: 25.55 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.76) and mild whole brain atrophy (Z-score -1.26), along with mild entorhinal cortex atrophy (Z-score -1.33), but hippocampal volume is normal (Z-score -0.74). Cognitive testing reveals a high MMSE (29) but borderline MoCA (24), with normal CSF biomarkers (Aβ, T-tau, P-tau) and moderate AV45 (amyloid PET) elevation.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to structural changes and borderline MoCA, despite normal CSF biomarkers).  \n**Confidence:** **Medium** (conflicting markers—structural atrophy and AV45 elevation suggest neurodegeneration, but preserved MMSE and normal CSF reduce certainty).",
  "timestamp": "2025-07-26T15:35:08.138364"
}