{
  "ptid_time": "135_S_4954_2012-09-24",
  "img_path": "/data/qiuhui/data/adni/images/135_S_4954/2012-09-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 38,209 mm³, 27.3% above the reference mean. With a Z-score of 0.65 (74.1th percentile), this represents normal volume ; whole brain volume measures 1,134,160 mm³, 0.0% below the reference mean. With a Z-score of -0.00 (49.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,506 mm³, 17.8% below the reference mean. With a Z-score of -1.23 (11.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 21,382 mm³, 7.4% above the reference mean. With a Z-score of 0.62 (73.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 27,340 mm³, 22.0% above the reference mean. With a Z-score of 1.81 (96.5th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 61.1 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Cardiovascular; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Smoking. MMSE: 25.0. MoCA: 23.0. Logical Memory: 3.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.26 SUVR (mild elevated); Amyloid beta: 816.40 pg/mL (normal ); Total tau: 234.60 pg/mL (normal ); Phosphorylated tau: 24.52 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild atrophy in the entorhinal cortex (Z-score -1.23, 11th percentile), which is an early marker of Alzheimer's pathology, but other brain volumes are normal or even enlarged (e.g., middle temporal gyrus). Cognitive scores (MMSE 25, MoCA 23) are borderline but not severely impaired. Biomarkers (Aβ, T-tau, P-tau) are normal, though AV45 (amyloid PET) is mildly elevated, suggesting possible early amyloid deposition.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting findings—entorhinal atrophy and elevated AV45 suggest early neurodegeneration, but normal biomarkers and borderline cognitive scores complicate the picture).",
  "timestamp": "2025-07-26T15:46:45.243607"
}