{
  "ptid_time": "109_S_4531_2012-03-13",
  "img_path": "/data/qiuhui/data/adni/images/109_S_4531/2012-03-13/t1.nii.gz",
  "img_finding": "Image findings: whole brain volume measures 1,061,360 mm³, 1.7% below the reference mean. With a Z-score of -0.22 (41.4th percentile), this represents normal volume ; entorhinal cortex volume measures 3,291 mm³, 19.7% below the reference mean. With a Z-score of -1.34 (9.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 19,642 mm³, 4.3% above the reference mean. With a Z-score of 0.36 (64.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,882 mm³, 11.9% above the reference mean. With a Z-score of 1.07 (85.8th percentile), this represents mild enlargement. ",
  "text_data": "Age is 73.7 years. Gender is Male. Education: 20 years. Handedness: Right. Race: Asian. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Allergies or Drug Sensitivities. MMSE: 24.0. MoCA: 21.0. Logical Memory: 5.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.30 SUVR (moderate elevated); Amyloid beta: 464.80 pg/mL (mild reduced); Total tau: 185.20 pg/mL (normal ); Phosphorylated tau: 19.32 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows mild atrophy (Z-score -1.34, 9th percentile), which is an early marker of Alzheimer’s pathology, while whole brain volume is normal. Cognitive scores (MMSE 24, MoCA 21) suggest mild impairment, and biomarker data (moderately elevated AV45, mildly reduced Aβ) support amyloid deposition.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology)  \n**Confidence:** **Medium** (cognitive scores and entorhinal atrophy align with MCI, but tau biomarkers are normal, and fusiform/middle temporal volumes are paradoxically enlarged).",
  "timestamp": "2025-07-26T11:34:47.573595"
}