{
  "ptid_time": "057_S_4888_2012-08-03",
  "img_path": "/data/qiuhui/data/adni/images/057_S_4888/2012-08-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,357 mm³, 21.2% below the reference mean. With a Z-score of -0.51 (30.6th percentile), this represents normal volume ; hippocampal volume measures 5,860 mm³, 22.5% below the reference mean. With a Z-score of -2.19 (1.4th percentile), this represents significant atrophy; whole brain volume measures 1,205,220 mm³, 11.7% above the reference mean. With a Z-score of 1.51 (93.5th percentile), this represents moderate enlargement; entorhinal cortex volume measures 2,946 mm³, 28.2% below the reference mean. With a Z-score of -1.91 (2.8th percentile), this represents moderate atrophy; fusiform gyrus volume measures 21,844 mm³, 16.0% above the reference mean. With a Z-score of 1.36 (91.3th percentile), this represents mild enlargement; middle temporal gyrus volume measures 21,826 mm³, 2.3% above the reference mean. With a Z-score of 0.21 (58.1th percentile), this represents normal volume . ",
  "text_data": "Age is 74.8 years. Gender is Male. Education: 12 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Major Surgical Procedures. MMSE: 25.0. MoCA: 21.0. Logical Memory: 0.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.22 SUVR (mild elevated); Amyloid beta: 876.80 pg/mL (normal ); Total tau: 311.50 pg/mL (normal ); Phosphorylated tau: 31.00 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The hippocampal and entorhinal cortex volumes show significant atrophy (Z-scores of -2.19 and -1.91, respectively), which are key regions affected in Alzheimer's disease. The MMSE (25) and MoCA (21) scores indicate mild cognitive impairment, supported by mildly elevated P-tau and AV45 (suggestive of amyloid pathology). However, Aβ and T-tau are normal, which complicates the picture.  \nDiagnosis: MCI (likely due to Alzheimer's pathology)  \nConfidence: Medium (due to conflicting biomarker results but strong structural and cognitive evidence)",
  "timestamp": "2025-07-26T08:13:32.289337"
}