{
  "ptid_time": "127_S_2213_2010-12-02",
  "img_path": "/data/qiuhui/data/adni/images/127_S_2213/2010-12-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,281 mm³, 15.4% below the reference mean. With a Z-score of -0.42 (33.9th percentile), this represents normal volume ; hippocampal volume measures 6,115 mm³, 5.9% below the reference mean. With a Z-score of -0.47 (32.0th percentile), this represents normal volume ; whole brain volume measures 854,997 mm³, 7.9% below the reference mean. With a Z-score of -0.95 (17.2th percentile), this represents normal volume ; entorhinal cortex volume measures 2,674 mm³, 22.8% below the reference mean. With a Z-score of -1.23 (10.9th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,580 mm³, 3.3% below the reference mean. With a Z-score of -0.25 (40.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,896 mm³, 6.3% below the reference mean. With a Z-score of -0.56 (28.8th percentile), this represents normal volume . ",
  "text_data": "Age is 82.3 years. Gender is Female. Education: 14 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Endocrine-Metabolic; Smoking; Malignancy; Major Surgical Procedures. MMSE: 30.0. MoCA: 20.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.30 SUVR (moderate elevated); Amyloid beta: 1124.00 pg/mL (normal ); Total tau: 322.80 pg/mL (mild elevated); Phosphorylated tau: 30.59 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild atrophy in the entorhinal cortex but otherwise normal volumes in other regions, including the hippocampus. The MMSE score is normal (30/30), but the MoCA score (20/30) suggests mild cognitive impairment. Biomarkers indicate normal Aβ but elevated T-tau, P-tau, and AV45, which may suggest early neurodegenerative changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting MMSE/MoCA results and biomarker profile, but structural changes support MCI over dementia)",
  "timestamp": "2025-07-26T13:11:16.221888"
}