{
  "ptid_time": "141_S_4160_2011-09-04",
  "img_path": "/data/qiuhui/data/adni/images/141_S_4160/2011-09-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 66,518 mm³, 72.7% above the reference mean. With a Z-score of 1.74 (95.9th percentile), this represents moderate enlargement; hippocampal volume measures 6,811 mm³, 9.9% below the reference mean. With a Z-score of -0.97 (16.7th percentile), this represents normal volume ; whole brain volume measures 1,083,260 mm³, 0.4% above the reference mean. With a Z-score of 0.05 (51.9th percentile), this represents normal volume ; entorhinal cortex volume measures 2,562 mm³, 37.5% below the reference mean. With a Z-score of -2.54 (0.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,575 mm³, 22.6% below the reference mean. With a Z-score of -1.93 (2.7th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 19,834 mm³, 7.1% below the reference mean. With a Z-score of -0.63 (26.3th percentile), this represents normal volume . ",
  "text_data": "Age is 74.1 years. Gender is Male. Education: 12 years. Handedness: Left. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Endocrine-Metabolic; Hematopoietic-Lymphatic; Smoking; Malignancy; Major Surgical Procedures. MMSE: 25.0. MoCA: 21.0. Logical Memory: 7.0. Laboratory findings: Vitamin B12: 918.00 (significant elevated); Total Bilirubin: 1.30 (profound elevated); Serum Glucose: 68.00 (significant reduced); Direct Bilirubin: 0.30 (significant elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.96 SUVR (mild reduced); Amyloid beta: 1035.00 pg/mL (normal ); Total tau: 126.30 pg/mL (mild reduced); Phosphorylated tau: 10.84 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the entorhinal cortex and moderate atrophy in the fusiform gyrus, both key regions affected in Alzheimer's disease (AD). Ventricular enlargement is also present, suggesting neurodegeneration. However, hippocampal volume is normal, and CSF biomarkers (Aβ, T-tau, P-tau) do not strongly support AD. Cognitive scores (MMSE 25, MoCA 21) indicate mild impairment but not severe dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural changes suggest neurodegeneration, but biomarker and cognitive profiles are not fully consistent with AD. APOE4-negative status and normal Aβ reduce certainty.)",
  "timestamp": "2025-07-26T17:01:57.501267"
}