{
  "ptid_time": "130_S_4605_2012-03-26",
  "img_path": "/data/qiuhui/data/adni/images/130_S_4605/2012-03-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 37,054 mm³, 0.2% above the reference mean. With a Z-score of 0.01 (50.3th percentile), this represents normal volume ; hippocampal volume measures 6,269 mm³, 3.5% below the reference mean. With a Z-score of -0.28 (39.0th percentile), this represents normal volume ; whole brain volume measures 1,042,930 mm³, 12.4% above the reference mean. With a Z-score of 1.48 (93.1th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,517 mm³, 1.6% above the reference mean. With a Z-score of 0.08 (53.4th percentile), this represents normal volume ; fusiform gyrus volume measures 18,959 mm³, 17.7% above the reference mean. With a Z-score of 1.33 (90.8th percentile), this represents mild enlargement; middle temporal gyrus volume measures 21,037 mm³, 16.7% above the reference mean. With a Z-score of 1.49 (93.1th percentile), this represents mild enlargement. ",
  "text_data": "Age is 84.7 years. Gender is Female. Education: 17 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Malignancy; Major Surgical Procedures. MMSE: 29.0. MoCA: 22.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.02 SUVR (normal ); Amyloid beta: 817.70 pg/mL (normal ); Total tau: 317.90 pg/mL (normal ); Phosphorylated tau: 28.01 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements show normal or mildly enlarged structures, with no significant atrophy in key regions like the hippocampus or entorhinal cortex. The MMSE score of 29 is within the normal range, but the MoCA score of 22 suggests mild cognitive impairment (MCI). However, all biomarkers (Aβ, T-tau, P-tau, AV45) are normal, and there is no APOE4 risk allele, making dementia less likely.  \n\n**Diagnosis:** MCI  \n**Confidence:** Medium (due to the discrepancy between MMSE and MoCA, but normal biomarkers and imaging suggest a non-Alzheimer's etiology for the",
  "timestamp": "2025-07-26T14:49:41.843332"
}