{
  "ptid_time": "005_S_5038_2012-12-13",
  "img_path": "/data/qiuhui/data/adni/images/005_S_5038/2012-12-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 96,302 mm³, 104.8% above the reference mean. With a Z-score of 3.04 (99.9th percentile), this represents profound enlargement; hippocampal volume measures 5,945 mm³, 14.7% below the reference mean. With a Z-score of -1.27 (10.2th percentile), this represents mild atrophy; whole brain volume measures 985,072 mm³, 4.3% below the reference mean. With a Z-score of -0.56 (28.7th percentile), this represents normal volume . ",
  "text_data": "Age is 81.5 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Endocrine-Metabolic; Gastrointestinal; Smoking; Malignancy; Major Surgical Procedures. MMSE: 25.0. MoCA: 18.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.87 SUVR (moderate reduced); Amyloid beta: 553.00 pg/mL (mild reduced); Total tau: 138.60 pg/mL (mild reduced); Phosphorylated tau: 12.57 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant ventricular enlargement (Z-score 3.04) and mild hippocampal atrophy (Z-score -1.27), along with moderately reduced amyloid (AV45) and mildly reduced CSF biomarkers (Aβ, T-tau, P-tau). Cognitive testing reveals borderline MMSE (25/30) and impaired MoCA (18/30), suggesting notable cognitive deficits.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype given hippocampal atrophy and cognitive deficits, but not severe enough for dementia).  \n\n**Confidence:** **Medium** (biomarkers suggest neurodegeneration, but CSF findings are atypical for AD, and APOE4-negative status reduces AD likelihood; vascular or mixed pathology may contribute).",
  "timestamp": "2025-07-25T21:24:48.283424"
}