{
  "ptid_time": "130_S_5258_2015-08-17",
  "img_path": "/data/qiuhui/data/adni/images/130_S_5258/2015-08-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,239 mm³, 11.3% above the reference mean. With a Z-score of 0.26 (60.2th percentile), this represents normal volume ; hippocampal volume measures 6,794 mm³, 4.5% below the reference mean. With a Z-score of -0.41 (34.0th percentile), this represents normal volume ; whole brain volume measures 819,772 mm³, 15.9% below the reference mean. With a Z-score of -2.00 (2.3th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,895 mm³, 6.0% above the reference mean. With a Z-score of 0.37 (64.5th percentile), this represents normal volume ; fusiform gyrus volume measures 14,826 mm³, 12.9% below the reference mean. With a Z-score of -1.17 (12.1th percentile), this represents mild atrophy; middle temporal gyrus volume measures 13,490 mm³, 29.6% below the reference mean. With a Z-score of -2.57 (0.5th percentile), this represents significant atrophy. ",
  "text_data": "Age is 79.9 years. Gender is Female. Education: 12 years. MMSE: 29.0. MoCA: 23.0. Logical Memory: 9.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.26 SUVR (mild elevated); Amyloid beta: 945.80 pg/mL (normal ); Total tau: 299.70 pg/mL (normal ); Phosphorylated tau: 29.42 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "Reasoning: The patient exhibits significant whole brain atrophy (Z-score -2.00) and severe middle temporal gyrus atrophy (Z-score -2.57), alongside mild fusiform gyrus atrophy. Despite normal hippocampal and entorhinal cortex volumes, the MoCA score of 23 suggests cognitive impairment. Mildly elevated P-tau and AV45 (amyloid PET) indicate possible underlying Alzheimer’s pathology, though Aβ and T-tau are normal.  \n\nDiagnosis: **Mild Cognitive Impairment (MCI)**  \nConfidence: **Medium** (due to conflicting biomarkers and preserved hippocampal volume despite significant atrophy elsewhere)",
  "timestamp": "2025-07-26T14:58:52.212240"
}