{
  "ptid_time": "041_S_5078_2013-02-15",
  "img_path": "/data/qiuhui/data/adni/images/041_S_5078/2013-02-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 45,145 mm³, 102.1% above the reference mean. With a Z-score of 2.56 (99.5th percentile), this represents significant enlargement; hippocampal volume measures 6,668 mm³, 13.2% below the reference mean. With a Z-score of -1.48 (6.9th percentile), this represents mild atrophy; whole brain volume measures 1,009,960 mm³, 1.9% below the reference mean. With a Z-score of -0.23 (40.8th percentile), this represents normal volume ; entorhinal cortex volume measures 4,034 mm³, 3.6% above the reference mean. With a Z-score of 0.28 (61.1th percentile), this represents normal volume ; fusiform gyrus volume measures 17,625 mm³, 3.2% below the reference mean. With a Z-score of -0.36 (35.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,841 mm³, 3.3% below the reference mean. With a Z-score of -0.29 (38.4th percentile), this represents normal volume . ",
  "text_data": "Age is 67.4 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Gastrointestinal; Renal-Genitourinary. MMSE: 30.0. MoCA: 26.0. Logical Memory: 23.0. Laboratory findings: . APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.10 SUVR (normal ); Amyloid beta: 1321.00 pg/mL (normal ); Total tau: 139.40 pg/mL (mild reduced); Phosphorylated tau: 11.44 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.56) and mild hippocampal atrophy (Z-score -1.48), which are suggestive of neurodegenerative changes. However, cognitive scores (MMSE 30, MoCA 26) are within normal limits, and biomarkers (Aβ normal, T-tau/P-tau mildly reduced, AV45 normal) do not strongly support Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to structural changes but normal cognition and conflicting biomarker profile)",
  "timestamp": "2025-07-26T07:23:46.315169"
}