{
  "ptid_time": "126_S_4494_2012-04-30",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4494/2012-04-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 26,738 mm³, 30.6% below the reference mean. With a Z-score of -0.73 (23.2th percentile), this represents normal volume ; hippocampal volume measures 5,629 mm³, 25.5% below the reference mean. With a Z-score of -2.49 (0.6th percentile), this represents significant atrophy; whole brain volume measures 1,107,750 mm³, 2.6% above the reference mean. With a Z-score of 0.34 (63.3th percentile), this represents normal volume ; entorhinal cortex volume measures 2,570 mm³, 37.3% below the reference mean. With a Z-score of -2.53 (0.6th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,849 mm³, 10.6% below the reference mean. With a Z-score of -0.90 (18.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 25,031 mm³, 17.3% above the reference mean. With a Z-score of 1.56 (94.0th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 71.1 years. Gender is Male. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Alcohol Abuse; Major Surgical Procedures. MMSE: 25.0. MoCA: 21.0. Logical Memory: 4.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.28 SUVR (moderate elevated); Amyloid beta: 308.50 pg/mL (moderate reduced); Total tau: 440.00 pg/mL (significant elevated); Phosphorylated tau: 46.73 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus and entorhinal cortex (both at <1st percentile), which are key regions affected in Alzheimer's disease. Elevated tau (T-tau and P-tau) and moderate Aβ reduction support AD pathology, while cognitive scores (MMSE 25, MoCA 21) indicate mild impairment.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI) due to Alzheimer’s disease**  \n**Confidence:** **High**  \n\n*(Note: The diagnosis is MCI rather than dementia because the cognitive scores, while impaired, are not severe enough to meet dementia criteria. The biomarker and imaging profile strongly align with early AD pathology.)*",
  "timestamp": "2025-07-26T12:46:09.693455"
}