{
  "ptid_time": "016_S_4584_2012-06-05",
  "img_path": "/data/qiuhui/data/adni/images/016_S_4584/2012-06-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,404 mm³, 19.0% above the reference mean. With a Z-score of 0.44 (66.8th percentile), this represents normal volume ; hippocampal volume measures 5,853 mm³, 17.7% below the reference mean. With a Z-score of -1.63 (5.2th percentile), this represents moderate atrophy; whole brain volume measures 892,452 mm³, 8.4% below the reference mean. With a Z-score of -1.06 (14.4th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,756 mm³, 2.3% above the reference mean. With a Z-score of 0.14 (55.5th percentile), this represents normal volume ; fusiform gyrus volume measures 15,436 mm³, 9.3% below the reference mean. With a Z-score of -0.84 (19.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,325 mm³, 9.6% below the reference mean. With a Z-score of -0.84 (20.2th percentile), this represents normal volume . ",
  "text_data": "Age is 78.3 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Musculoskeletal; Endocrine-Metabolic; Smoking; Major Surgical Procedures. MMSE: 27.0. MoCA: 22.0. Logical Memory: 8.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.39 SUVR (significant elevated); Amyloid beta: 806.00 pg/mL (normal ); Total tau: 359.00 pg/mL (mild elevated); Phosphorylated tau: 32.75 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate hippocampal atrophy (Z-score -1.63, 5.2th percentile) and mild whole-brain atrophy (Z-score -1.06, 14.4th percentile), which are concerning for neurodegeneration. Despite a normal MMSE (27), the MoCA (22) suggests mild cognitive impairment, supported by elevated AV45 (amyloid positivity) and mildly elevated tau biomarkers (T-tau, P-tau).  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology given amyloid positivity and hippocampal atrophy).  \n\n**Confidence:** **High** (due to clear structural and biomarker evidence of Alzheimer’s-related changes despite relatively preserved global cognition).  \n\n*Note: The Aβ being \"normal\" while AV45 is \"significant elevated\" may seem contradictory—this could reflect a discrepancy between CSF Aβ (if measured) and PET amyloid imaging. If CSF Aβ was used, the patient may still have amyloid deposition detectable on PET, reinforcing an Alzheimer’s profile.*",
  "timestamp": "2025-07-26T00:26:41.272698"
}