{
  "ptid_time": "052_S_4807_2014-08-07",
  "img_path": "/data/qiuhui/data/adni/images/052_S_4807/2014-08-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 35,592 mm³, 26.8% above the reference mean. With a Z-score of 0.61 (73.0th percentile), this represents normal volume ; hippocampal volume measures 7,439 mm³, 4.6% above the reference mean. With a Z-score of 0.42 (66.2th percentile), this represents normal volume ; whole brain volume measures 1,123,220 mm³, 15.2% above the reference mean. With a Z-score of 1.92 (97.3th percentile), this represents moderate enlargement; entorhinal cortex volume measures 2,663 mm³, 27.5% below the reference mean. With a Z-score of -1.69 (4.6th percentile), this represents moderate atrophy; fusiform gyrus volume measures 20,230 mm³, 18.9% above the reference mean. With a Z-score of 1.72 (95.7th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 17,309 mm³, 9.7% below the reference mean. With a Z-score of -0.84 (20.0th percentile), this represents normal volume . ",
  "text_data": "Age is 74.0 years. Gender is Female. Education: 16 years. MMSE: 28.0. MoCA: 22.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.27 SUVR (mild elevated); Amyloid beta: 776.20 pg/mL (normal ); Total tau: 686.30 pg/mL (profound elevated); Phosphorylated tau: 78.12 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.69, 4.6th percentile), which is a key early marker of Alzheimer's pathology. Despite normal hippocampal and whole brain volumes, the profound elevation in T-tau and P-tau, along with mild AV45 (amyloid) elevation, suggests underlying neurodegenerative changes. The MoCA score of 22 indicates mild cognitive impairment, while the MMSE of 28 is borderline normal.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—normal Aβ but elevated tau and AV45—and borderline cognitive scores)",
  "timestamp": "2025-07-26T07:50:23.637964"
}