{
  "ptid_time": "027_S_4869_2014-09-30",
  "img_path": "/data/qiuhui/data/adni/images/027_S_4869/2014-09-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,103 mm³, 14.1% below the reference mean. With a Z-score of -0.34 (36.8th percentile), this represents normal volume ; hippocampal volume measures 7,295 mm³, 3.5% below the reference mean. With a Z-score of -0.34 (36.7th percentile), this represents normal volume ; whole brain volume measures 1,075,430 mm³, 0.4% below the reference mean. With a Z-score of -0.05 (48.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,673 mm³, 10.4% below the reference mean. With a Z-score of -0.71 (24.0th percentile), this represents normal volume ; fusiform gyrus volume measures 18,905 mm³, 0.4% above the reference mean. With a Z-score of 0.03 (51.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,569 mm³, 1.1% above the reference mean. With a Z-score of 0.10 (53.9th percentile), this represents normal volume . ",
  "text_data": "Age is 79.2 years. Gender is Male. Education: 19 years. MMSE: 29.0. MoCA: 20.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.07 SUVR (normal ); Total tau: 225.10 pg/mL (normal ); Phosphorylated tau: 17.17 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volumes (ventricular, hippocampal, whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus) are all within normal ranges based on Z-scores and percentiles. However, the MoCA score of 20 suggests mild cognitive impairment (MCI), while the MMSE score of 29 is within the normal range. Biomarkers (T-tau, P-tau, AV45) are normal, and there is no APOE4 risk allele.  \n\n**Diagnosis:** **MCI** (due to the discrepancy between MoCA and MMSE, with MoCA indicating cognitive impairment despite normal imaging and biomarkers).  \n\n**Confidence:** **Medium** (due to conflicting cognitive test results, but MoCA is more sensitive to early cognitive decline).",
  "timestamp": "2025-07-26T03:59:32.486532"
}