{
  "ptid_time": "009_S_4530_2012-02-14",
  "img_path": "/data/qiuhui/data/adni/images/009_S_4530/2012-02-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 62,746 mm³, 62.9% above the reference mean. With a Z-score of 1.51 (93.4th percentile), this represents moderate enlargement; hippocampal volume measures 6,749 mm³, 10.7% below the reference mean. With a Z-score of -1.05 (14.8th percentile), this represents mild atrophy; whole brain volume measures 1,083,790 mm³, 0.4% above the reference mean. With a Z-score of 0.05 (52.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,381 mm³, 17.5% below the reference mean. With a Z-score of -1.19 (11.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 13,152 mm³, 30.2% below the reference mean. With a Z-score of -2.57 (0.5th percentile), this represents significant atrophy; middle temporal gyrus volume measures 20,506 mm³, 3.9% below the reference mean. With a Z-score of -0.35 (36.3th percentile), this represents normal volume . ",
  "text_data": "Age is 75.9 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Hematopoietic-Lymphatic; Malignancy; Major Surgical Procedures. MMSE: 30.0. MoCA: 23.0. Logical Memory: 10.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.30 SUVR (moderate elevated); Amyloid beta: 592.30 pg/mL (mild reduced); Total tau: 205.30 pg/mL (normal ); Phosphorylated tau: 19.88 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the fusiform gyrus and mild atrophy in the hippocampus and entorhinal cortex, which are regions commonly affected in Alzheimer's disease. The MoCA score of 23 suggests mild cognitive impairment, while the MMSE of 30 is normal, indicating possible early-stage cognitive decline. Elevated AV45 (amyloid PET) and reduced Aβ (CSF) support amyloid pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology)  \n**Confidence:** **Medium** (due to conflicting MMSE/MoCA scores but strong biomarker and imaging support)",
  "timestamp": "2025-07-25T22:21:08.027109"
}