{
  "ptid_time": "021_S_4419_2011-12-19",
  "img_path": "/data/qiuhui/data/adni/images/021_S_4419/2011-12-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,095 mm³, 27.9% below the reference mean. With a Z-score of -0.70 (24.2th percentile), this represents normal volume ; hippocampal volume measures 7,976 mm³, 3.8% above the reference mean. With a Z-score of 0.43 (66.5th percentile), this represents normal volume ; whole brain volume measures 939,272 mm³, 8.7% below the reference mean. With a Z-score of -1.09 (13.8th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,453 mm³, 11.3% below the reference mean. With a Z-score of -0.88 (19.1th percentile), this represents normal volume ; fusiform gyrus volume measures 17,529 mm³, 3.7% below the reference mean. With a Z-score of -0.42 (33.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,367 mm³, 20.2% below the reference mean. With a Z-score of -1.80 (3.6th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 63.8 years. Gender is Female. Education: 18 years. Handedness: Right. Race: Black or African American. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Smoking; Major Surgical Procedures. MMSE: 30.0. MoCA: 28.0. Logical Memory: 11.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.27 SUVR (moderate elevated); Amyloid beta: 555.60 pg/mL (mild reduced); Total tau: 152.60 pg/mL (mild reduced); Phosphorylated tau: 15.24 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild to moderate atrophy in the whole brain and middle temporal gyrus, but other regions (hippocampus, entorhinal cortex, fusiform gyrus) are within normal ranges. Cognitive scores (MMSE 30, MoCA 28) are intact, and biomarkers show only mild Aβ reduction and moderate AV45 elevation, with normal P-tau.  \n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (Atrophy in some regions and AV45 elevation suggest early changes, but preserved cognition and lack of significant biomarker abnormalities argue against MCI/dementia at this stage.)",
  "timestamp": "2025-07-26T01:47:39.007509"
}