{
  "ptid_time": "037_S_4214_2011-12-13",
  "img_path": "/data/qiuhui/data/adni/images/037_S_4214/2011-12-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 83,689 mm³, 117.3% above the reference mean. With a Z-score of 2.81 (99.8th percentile), this represents significant enlargement; hippocampal volume measures 7,326 mm³, 3.1% below the reference mean. With a Z-score of -0.30 (38.2th percentile), this represents normal volume ; whole brain volume measures 946,272 mm³, 12.3% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; entorhinal cortex volume measures 4,038 mm³, 1.5% below the reference mean. With a Z-score of -0.10 (45.9th percentile), this represents normal volume ; fusiform gyrus volume measures 16,924 mm³, 10.2% below the reference mean. With a Z-score of -0.87 (19.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,121 mm³, 15.1% below the reference mean. With a Z-score of -1.36 (8.8th percentile), this represents mild atrophy. ",
  "text_data": "Age is 74.2 years. Gender is Male. Education: 20 years. Handedness: Left. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 30.0. MoCA: 20.0. Logical Memory: 8.0. Laboratory findings: Vitamin B12: 4337.00 (profound elevated); Creatine Kinase: 238.00 (significant elevated); Alkaline Phosphatase: 32.00 (significant reduced); GGT: 126.00 (profound elevated); ALT (SGPT): 53.00 (profound elevated); AST (SGOT): 50.00 (profound elevated); Urea Nitrogen: 34.00 (profound elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.00 SUVR (normal ); Amyloid beta: 879.90 pg/mL (normal ); Total tau: 115.80 pg/mL (moderate reduced); Phosphorylated tau: 9.39 pg/mL (moderate reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.81) and moderate whole-brain atrophy (Z-score -1.60), alongside a normal hippocampal volume. The MoCA score of 20/30 suggests cognitive impairment, but Aβ is normal, and APOE4 is negative, making Alzheimer's less likely. The reduced T-tau and P-tau levels are atypical for AD.  \n**Diagnosis:** **MCI** (likely non-AD etiology, possibly vascular or other neurodegenerative cause)  \n**Confidence:** **Medium** (due to conflicting biomarkers and preserved hippocampal volume despite cognitive deficits)",
  "timestamp": "2025-07-26T06:42:41.774222"
}