{
  "ptid_time": "137_S_4852_2012-10-23",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4852/2012-10-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 24,226 mm³, 8.5% above the reference mean. With a Z-score of 0.21 (58.4th percentile), this represents normal volume ; hippocampal volume measures 6,819 mm³, 11.3% below the reference mean. With a Z-score of -1.26 (10.3th percentile), this represents mild atrophy; whole brain volume measures 999,712 mm³, 2.9% below the reference mean. With a Z-score of -0.36 (36.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,683 mm³, 5.4% below the reference mean. With a Z-score of -0.42 (33.8th percentile), this represents normal volume ; fusiform gyrus volume measures 17,699 mm³, 2.8% below the reference mean. With a Z-score of -0.32 (37.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,187 mm³, 3.3% above the reference mean. With a Z-score of 0.29 (61.4th percentile), this represents normal volume . ",
  "text_data": "Age is 64.1 years. Gender is Female. Education: 20 years. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 26.0. MoCA: 22.0. Logical Memory: 4.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.40 SUVR (significant elevated); Amyloid beta: 685.70 pg/mL (normal ); Total tau: 538.00 pg/mL (profound elevated); Phosphorylated tau: 58.19 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.26, 10.3th percentile), which is a key biomarker for Alzheimer's disease (AD). The cognitive scores (MMSE 26, MoCA 22) suggest mild cognitive impairment, and the CSF biomarkers (elevated T-tau, P-tau, and AV45 with normal Aβ) are consistent with AD pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI) due to Alzheimer’s disease**  \n**Confidence:** **High**  \n\n*(The diagnosis is MCI rather than dementia because the cognitive decline is not severe enough to significantly impair daily functioning, but the biomarker profile strongly suggests underlying AD pathology.)*",
  "timestamp": "2025-07-26T16:45:09.513820"
}